MEDICARE: MATTHEW TEAGUE

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	225100000X	Physical Therapist		IL

General Provider Information

NPI Number	:	1932032091
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW TEAGUE

Provider Business Mailing Address
First Line	:	6108 S GREENWOOD AVE APT B
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60637-2766
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	18410 GOVERNORS HWY
Second Line	:
City	:	HOMEWOOD
State	:	IL
Zip	:	60430-2911
Country	:	US
Telephone Number	:	708-852-2535
Fax Number	:

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

Provider Enumeration Date	:	06/06/2026
Last Update Date	:	06/06/2026

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Directions to “ MATTHEW TEAGUE ” Practice Location

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