| Mr Keith David Schroeder, | |
|
400 E 4th St, Beardstown, IL 62618-1307 | |
| (217) 323-7006 | |
| Not Available |
| Full Name | Mr Keith David Schroeder |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist |
| Location | 400 E 4th St, Beardstown, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295541571 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 070011507 (Illinois) | Primary |
| Provider Name | Beardstown Therapy Clinic |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1700596442 PECOS PAC ID: 6507223989 Enrollment ID: O20230530001670 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Keith David Schroeder, 400 E 4th St, Beardstown, IL 62618-1307 Ph: (217) 323-7006 | Mr Keith David Schroeder, 400 E 4th St, Beardstown, IL 62618-1307 Ph: (217) 323-7006 |
Larissa Sorrells, Physical Therapist Medicare: Medicare Enrolled Practice Location: 400 E 4th St, Beardstown, IL 62618 Phone: 217-248-5795 | |
Addison Paige Lagemann, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 8 Walker Ave, Beardstown, IL 62618 Phone: 217-320-9939 | |
Caitlin Mahoney, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 400 E 4th St, Beardstown, IL 62618 Phone: 217-323-7006 |