| William Jerome Loethen, | |
|
2110 Fox Dr Ste D, Champaign, IL 61820-7553 | |
| (217) 398-9800 | |
| Not Available |
| Full Name | William Jerome Loethen |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist In Private Practice |
| Location | 2110 Fox Dr Ste D, Champaign, 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 |
|---|---|---|---|
| 1912848250 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | (NU) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Ivyrehab Physical Therapy, Occupational Therapy And Speech Language Pa | 7012997638 | 385 |
| Provider Name | Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Path |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1376917187 PECOS PAC ID: 7012997638 Enrollment ID: O20160304000277 |
| Mailing Address | Practice Location Address |
|---|---|
| William Jerome Loethen, 1901 Mayberry Dr, Columbia, MO 65202-3856 Ph: (573) 673-8354 | William Jerome Loethen, 2110 Fox Dr Ste D, Champaign, IL 61820-7553 Ph: (217) 398-9800 |
Mrs. Angela J Cusick, P.T. Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 3101 Fields South Dr, Champaign, IL 61822 Phone: 217-366-1323 |
Jasmine A Evans, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 101 W University Ave, Champaign, IL 61820 Phone: 217-366-1323 |
Blake P Doane, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 2906 Crossing Ct, Champaign, IL 61822 Phone: 217-398-9800 Fax: 217-366-0037 |
Keith A Sternhagen, PT, MSPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2906 Crossing Ct, Champaign, IL 61822 Phone: 217-356-6543 Fax: 217-356-8010 |
Benjamin Kim, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 2906 Crossing Ct, Champaign, IL 61822 Phone: 217-398-9800 Fax: 217-366-0036 |
Whitney A Walker, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2403 Village Green Pl, Champaign, IL 61822 Phone: 217-359-4549 Fax: 217-359-4620 |
Jamie Lee Plackett, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 3105 Village Office Pl, Champaign, IL 61822 Phone: 217-841-0352 |