MEDICARE: ALICIA E VALENCIA-UNTERBRUNNER PT

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	11157-24	WI
2	225100000X	Physical Therapist	070018545	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932347234
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALICIA E VALENCIA-UNTERBRUNNER PT

Provider Business Mailing Address
First Line	:	1233 W ADAMS ST STE 1020
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60607-2801
Country	:	US
Telephone Number	:	312-243-8487
Fax Number	:

Provider Business Practice Location Address
First Line	:	1921 W IRVING PARK RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60613-2407
Country	:	US
Telephone Number	:	312-243-8487
Fax Number	:

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

Provider Enumeration Date	:	01/26/2009
Last Update Date	:	06/26/2024

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