MEDICARE: MS. ERIN MICHELLE WHITE P.T.

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	172M00000X	Mechanotherapist	070.021239	IL

General Provider Information

NPI Number	:	1932194412
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ERIN MICHELLE WHITE P.T.

Provider Business Mailing Address
First Line	:	29 E MOSELEY RD
Second Line	:
City	:	PALATINE
State	:	IL
Zip	:	60074-1155
Country	:	US
Telephone Number	:	847-868-6383
Fax Number	:	847-348-2158

Provider Business Practice Location Address
First Line	:	777 LAKE ZURICH RD
Second Line	:	SUITE 125B
City	:	BARRINGTON
State	:	IL
Zip	:	60010-3106
Country	:	US
Telephone Number	:	847-466-1025
Fax Number	:	847-466-1101

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

Provider Enumeration Date	:	09/12/2005
Last Update Date	:	06/17/2015

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