| Jordan Vandyke, | |
|
200 Health Care Dr, Greenville, IL 62246-1154 | |
| (618) 664-2626 | |
| Not Available |
| Full Name | Jordan Vandyke |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist In Private Practice |
| Experience | 7 Years |
| Location | 200 Health Care Dr, Greenville, Illinois |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841836533 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 070024599 (Illinois) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Jdv Physical Therapy Llc | 6406205509 | 3 |
| Provider Name | Imove Telept, Llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1548896442 PECOS PAC ID: 0244661544 Enrollment ID: O20200521000767 |
| Provider Name | Jdv Physical Therapy Llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1861274284 PECOS PAC ID: 6406205509 Enrollment ID: O20231214002860 |
| Mailing Address | Practice Location Address |
|---|---|
| Jordan Vandyke, 21 Chelsea Rd, Collinsville, IL 62234-4871 Ph: () - | Jordan Vandyke, 200 Health Care Dr, Greenville, IL 62246-1154 Ph: (618) 664-2626 |
Mrs. Tammy Sue Tulacro, LPT/LAT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1105 E Harris Ave, Greenville, IL 62246 Phone: 618-664-4600 | |
Greenville Rehab & Pain Clinic Sc Physical Therapist Medicare: Medicare Enrolled Practice Location: 1105 E Harris Ave, Greenville, IL 62246 Phone: 618-664-4600 Fax: 618-664-2136 | |
Anna White, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 200 Health Care Dr, Greenville, IL 62246 Phone: 618-651-0444 | |
Mr. Michael P Irving, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 200 S 3rd St, Greenville, IL 62246 Phone: 618-664-9720 Fax: 618-664-9721 | |
Lacey Wiegmann, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 200 Health Care Dr, Greenville, IL 62246 Phone: 618-664-2626 | |
Susan Elizabeth Vandenbergh, P.T. Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 605 S Dewey St, Greenville, IL 62246 Phone: 618-627-7748 |