MEDICARE: MRS. AIMEE AURELIO TABILON 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	225100000X	Physical Therapist	070.018905	IL

General Provider Information

NPI Number	:	1942558937
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AIMEE AURELIO TABILON P.T.

Provider Business Mailing Address
First Line	:	16089 POPPYSEED CIR UNIT 2008
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33484-6314
Country	:	US
Telephone Number	:	561-496-7993
Fax Number	:	561-496-0589

Provider Business Practice Location Address
First Line	:	3647 W FOSTER AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-5527
Country	:	US
Telephone Number	:	224-244-0512
Fax Number	:

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

Provider Enumeration Date	:	08/22/2012
Last Update Date	:	01/03/2025

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