Michele Wylde, PT, ATC is a medicare enrolled "Physical Therapist" provider in Waterman, Illinois. Her current practice location is
320 W Adams St, Waterman, Illinois. You can reach out to her office (for appointments etc.) via phone at
(815) 264-8600.
Michele Wylde is licensed to practice in Illinois (license number 070014036) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1962730416.
Healthcare Provider's Profile
| Full Name | Michele Wylde |
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| Gender | Female |
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| Speciality | Physical Therapist |
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| Location | 320 W Adams St, Waterman, Illinois |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1962730416
- Provider Enumeration Date: 11/20/2009
- Last Update Date: 07/01/2025
Medicare PECOS Information:
- PECOS PAC ID: 1759651185
- Enrollment ID: I20170718003041
Medical Identifiers
Medical identifiers for Michele Wylde such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1962730416 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 2251S0007X | Physical Therapist - Sports | 070.014036 (Illinois) | Secondary |
| 2251X0800X | Physical Therapist - Orthopedic | 070.014036 (Illinois) | Secondary |
| 261QP2000X | Clinic/center - Physical Therapy | 070.014036 (Illinois) | Secondary |
| 225100000X | Physical Therapist | 070014036 (Illinois) | Primary |
| 225100000X | Physical Therapist | 070.014036 (Illinois) | Secondary |
| 2251G0304X | Physical Therapist - Geriatrics | 070.014036 (Illinois) | Secondary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Michele Wylde allows following entities to bill medicare on her behalf.
| Provider Name | Wylde Physical Therapy Llc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1740406123
PECOS PAC ID: 0941257760
Enrollment ID: O20050405000050 |
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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. Michele Wylde 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 |
|---|
Michele Wylde, PT, ATC
Po Box 98,
Waterman, IL 60556-0098
Ph: (815) 264-8600 | Michele Wylde, PT, ATC
320 W Adams St,
Waterman, IL 60556-4000
Ph: (815) 264-8600 |
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