| Vidit Atul Phanse, | |
|
620 W Bridgeport St, White Hall, IL 62092-1001 | |
| (217) 374-6714 | |
| Not Available |
| Full Name | Vidit Atul Phanse |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist In Private Practice |
| Experience | 8 Years |
| Location | 620 W Bridgeport St, White Hall, 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 |
|---|---|---|---|
| 1043731540 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 070.022922 (Illinois) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Athletic And Therapeutic Institute Of Bourbonnais, Llc | 4183692577 | 137 |
| Provider Name | Athletic And Therapeutic Institute Of Naperville, Llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1023129681 PECOS PAC ID: 8325014020 Enrollment ID: O20040903000494 |
| Provider Name | Athletic And Therapeutic Institute Of Bourbonnais, Llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1861503542 PECOS PAC ID: 4183692577 Enrollment ID: O20040923000220 |
| Mailing Address | Practice Location Address |
|---|---|
| Vidit Atul Phanse, 790 Remington Blvd, Bolingbrook, IL 60440-4909 Ph: () - | Vidit Atul Phanse, 620 W Bridgeport St, White Hall, IL 62092-1001 Ph: (217) 374-6714 |
Loida Lim Baculanta, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 549 N Main St, Apt 4, White Hall, IL 62092 Phone: 217-416-8032 | |
Netherine Lann Valencia Agsalda, RPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 620 W Bridgeport St., White Hall Nursing And Rehab, White Hall, IL 62092 Phone: 217-374-2144 |