Individual ProviderAndrea StaleyPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address4801 W Peterson Ave, Suite 314, Chicago, IL 60646-5713(773) 777-4947(847) 324-3976PECOS EnrollmentBased on the most recent information from CMS, provider Andrea Staley does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 10:14 AM.Profile DetailsProvider ID1013248236Provider TypeIndividualFull NameStaley, AndreaCredentialPTGenderFemaleSole ProprietorNoEnumeration Date1/28/2010Last Updated3/17/2021Contact InformationPractice LocationPractice Address4801 W Peterson Ave, Suite 314, Chicago, IL 60646-5713Phone(773) 777-4947FaxUnlisted FaxMailing LocationMailing Address900 Rand Rd, Suite 300, Des Plaines, IL 60016-2359Phone(847) 324-3976FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseUnlisted Issuer