MEDICARE: KATHRYN AMY CHOATE MPT, CFMT

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	174400000X	Specialist	070014259	IL
2	225100000X	Physical Therapist	070014259	IL

General Provider Information

NPI Number	:	1932254414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN AMY CHOATE MPT, CFMT

Provider Business Mailing Address
First Line	:	1355 N SANDBURG TER APT 2008
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60610-7978
Country	:	US
Telephone Number	:	312-643-0994
Fax Number	:

Provider Business Practice Location Address
First Line	:	1355 N SANDBURG TER
Second Line	:	SUITE 2008
City	:	CHICAGO
State	:	IL
Zip	:	60610-2074
Country	:	US
Telephone Number	:	312-643-0994
Fax Number	:

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

Provider Enumeration Date	:	01/24/2007
Last Update Date	:	08/31/2016

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