MEDICARE: ROBERT STRAUCH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	056003559	IL

General Provider Information

NPI Number	:	1912475385
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT STRAUCH

Provider Business Mailing Address
First Line	:	739 PLEASANT AVE
Second Line	:
City	:	GLEN ELLYN
State	:	IL
Zip	:	60137-3842
Country	:	US
Telephone Number	:	630-545-9642
Fax Number	:

Provider Business Practice Location Address
First Line	:	1996 FRANCISCAN WAY
Second Line	:
City	:	WEST CHICAGO
State	:	IL
Zip	:	60185-6232
Country	:	US
Telephone Number	:	630-562-4242
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/05/2018
Last Update Date	:	11/05/2018

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