| Traci Kristine Martin, MS CCC-SLP | |
|
114 E Walnut St, Teutopolis, IL 62467-1154 | |
| (720) 545-8160 | |
| Not Available |
| Full Name | Traci Kristine Martin |
|---|---|
| Gender | Female |
| Speciality | Qualified Speech Language Pathologist |
| Experience | 23 Years |
| Location | 114 E Walnut St, Teutopolis, Illinois |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770664815 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 235Z00000X | Speech-language Pathologist | 4963 (Tennessee) | Secondary |
| 235Z00000X | Speech-language Pathologist | 146008086 (Illinois) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Empowerme Rehabilitation Illinois Llc | 2365718277 | 363 |
| Provider Name | Empowerme Rehabilitation Illinois Llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1679098263 PECOS PAC ID: 2365718277 Enrollment ID: O20171020001353 |
| Provider Name | Empowerme Wellness Kansas City Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1174118103 PECOS PAC ID: 9830504836 Enrollment ID: O20210317001954 |
| Mailing Address | Practice Location Address |
|---|---|
| Traci Kristine Martin, MS CCC-SLP 114 E Walnut St, Teutopolis, IL 62467-1154 Ph: (720) 545-8160 | Traci Kristine Martin, MS CCC-SLP 114 E Walnut St, Teutopolis, IL 62467-1154 Ph: (720) 545-8160 |
Mrs. Natasha Renee Ruholl, M.S., CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 16136 E 1485th Ave, Teutopolis, IL 62467 Phone: 217-343-1617 Fax: 833-799-0369 | |
Mrs. Patricai Ann Crawford, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 15561 N 1700th St, Teutopolis, IL 62467 Phone: 217-857-6644 | |
Mrs. Erin Hardiek, M.S. CCC- SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 609 W Southern Row, Teutopolis, IL 62467 Phone: 217-246-3226 | |
Kari Mcmanaway, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 309 E Main St, Teutopolis, IL 62467 Phone: 217-857-3232 | |
Vicky Simmons, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 309 E Main St, Teutopolis, IL 62467 Phone: 217-857-3232 | |
Lisa Jane Uthell, SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 16800 N 1650th St, Teutopolis, IL 62467 Phone: 217-857-1120 Fax: 217-857-1120 |