| Central Illinois Physical Therapy Professionals, Ltd | |
|
100 Professional Plz, Mattoon, IL 61938-9252 | |
| (217) 345-1245 | |
| (217) 345-1253 |
| Full Name | Central Illinois Physical Therapy Professionals, Ltd |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 100 Professional Plz, Mattoon, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124246939 | NPI | - | NPPES |
| 323429974001 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 070002766 (Illinois) | Primary |
| Provider Name | Richard W Kruckeberg |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1245362920 PECOS PAC ID: 4486819398 Enrollment ID: I20120627000226 |
| Provider Name | Emily Pisani |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1932547965 PECOS PAC ID: 9931334018 Enrollment ID: I20131025000844 |
| Mailing Address | Practice Location Address |
|---|---|
| Central Illinois Physical Therapy Professionals, Ltd 100 Professional Plz, Mattoon, IL 61938-9252 Ph: (217) 345-1245 | Central Illinois Physical Therapy Professionals, Ltd 100 Professional Plz, Mattoon, IL 61938-9252 Ph: (217) 345-1245 |
Kendall Giles, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1004 Health Center Dr, Mattoon, IL 61938 Phone: 217-258-2530 Fax: 217-258-4176 | |
Jennifer Uberfluss, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1000 Health Center Dr, Mattoon, IL 61938 Phone: 217-258-2525 | |
Elizabeth H Jensen, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1000 Health Center Dr, Mattoon, IL 61938 Phone: 217-235-3121 Fax: 217-235-3122 | |
Douglas A Henness, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1000 Health Center Dr, Mattoon, IL 61938 Phone: 217-258-2530 Fax: 217-258-4176 | |
Teri Lyn Miller, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1000 Health Center Dr, Mattoon, IL 61938 Phone: 217-258-2525 | |
Carla A Thomas, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1000 Health Center Dr, Mattoon, IL 61938 Phone: 217-258-2525 |