| Mary Ann Breault, LPT | |
|
1941 Harlem Rd, Loves Park, IL 61111-2747 | |
| (815) 986-4411 | |
| (815) 986-4414 |
| Full Name | Mary Ann Breault |
|---|---|
| Gender | Female |
| Speciality | Physical Therapist |
| Location | 1941 Harlem Rd, Loves Park, Illinois |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215063193 | NPI | - | NPPES |
| 10132053 | Other | IL | BCBS PROVIDER NUMBER |
| 020654168 | Other | IL | TAX ID |
| 070009033 | Other | IL | STATE LISCENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 070009033 (Illinois) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mary Ann Breault, LPT 1941 Harlem Rd, Loves Park, IL 61111-2747 Ph: (815) 986-4411 | Mary Ann Breault, LPT 1941 Harlem Rd, Loves Park, IL 61111-2747 Ph: (815) 986-4411 |
Dr. Casey Matthew Boyd, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1820 Windsor Rd, Loves Park, IL 61111 Phone: 815-986-4411 | |
Mr. Karlo Mark Garcia Corsino, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 7082 Sue Ct Apt 2, Loves Park, IL 61111 Phone: 847-431-7877 | |
Bailey Brauer, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 4401 Peak Dr, Loves Park, IL 61111 Phone: 815-668-7700 Fax: 815-668-7701 | |
Philip Raatz, Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 8451 Orth Rd, Loves Park, IL 61111 Phone: 779-696-2466 | |
Mr. Bernard Yaun, LPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 1521 E Riverside Blvd Ste 2, Loves Park, IL 61111 Phone: 815-668-4797 Fax: 815-516-1228 | |
Sheryl Mae Beltran, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 5657 Whispering Way, Loves Park, IL 61111 Phone: 815-914-5520 |