| Mrs Angela M Derrick, DPT | |
|
800 School St, Carrollton, IL 62016-1436 | |
| (217) 942-6946 | |
| Not Available |
| Full Name | Mrs Angela M Derrick |
|---|---|
| Gender | Female |
| Speciality | Physical Therapist |
| Location | 800 School St, Carrollton, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093775447 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | NM2654 (New Mexico) | Secondary |
| 225100000X | Physical Therapist | 070018073 (Illinois) | Primary |
| 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: O20210323000185 |
| Provider Name | Booher Health Llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1215620380 PECOS PAC ID: 8820459423 Enrollment ID: O20230728003061 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Angela M Derrick, DPT 402 Minard St, Jerseyville, IL 62052-2630 Ph: (575) 312-4439 | Mrs Angela M Derrick, DPT 800 School St, Carrollton, IL 62016-1436 Ph: (217) 942-6946 |
Ken Gray, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 800 School St, Carrollton, IL 62016 Phone: 217-942-6946 Fax: 217-942-9349 | |
Miss Abby Leigh Baalman, D.P.T. Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 314 5th St, Carrollton, IL 62016 Phone: 217-409-6405 Fax: 217-305-7282 | |
Morgan Stein, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 314 5th St, Carrollton, IL 62016 Phone: 217-324-8780 |