Central Illinois Physical Therapy Professionals, Ltd is a medicare enrolled "Physical Therapist" provider in Sullivan, Illinois. Their current practice location is
2 E Harrison St, Sullivan, Illinois. You can reach out to their office (for appointments etc.) via phone at
(217) 345-1245.
Central Illinois Physical Therapy Professionals, Ltd is licensed to practice in Illinois (license number 070002766) and it also participates in the medicare program. Central Illinois Physical Therapy Professionals, Ltd
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1124246939.
Healthcare Provider's Profile
| Full Name | Central Illinois Physical Therapy Professionals, Ltd |
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| Type | Facility |
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| Speciality | Physical Therapist |
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| Location | 2 E Harrison St, Sullivan, Illinois |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1124246939
- Provider Enumeration Date: 04/24/2007
- Last Update Date: 12/10/2025
Medicare PECOS Information:
- PECOS PAC ID: 3678735206
- Enrollment ID: O20120427000156
Medical Identifiers
Medical identifiers for Central Illinois Physical Therapy Professionals, Ltd such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1124246939 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 225100000X | Physical Therapist | 070002766 (Illinois) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Central Illinois Physical Therapy Professionals, Ltd acts as a billing entity for following providers:
| Provider Name | Richard W Kruckeberg |
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| Provider Type | Practitioner - Physical Therapist In Private Practice |
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| Provider Identifiers | NPI Number: 1245362920
PECOS PAC ID: 4486819398
Enrollment ID: I20120627000226 |
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| Provider Name | Emily Pisani |
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| Provider Type | Practitioner - Physical Therapist In Private Practice |
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| Provider Identifiers | NPI Number: 1932547965
PECOS PAC ID: 9931334018
Enrollment ID: I20131025000844 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Central Illinois Physical Therapy Professionals, Ltd is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Central Illinois Physical Therapy Professionals, Ltd
Po Box 101,
Sullivan, IL 61951-0101
Ph: (217) 345-1245 | Central Illinois Physical Therapy Professionals, Ltd
2 E Harrison St,
Sullivan, IL 61951-1905
Ph: (217) 345-1245 |
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