Shay N Farris, PTA
Individual provider Active NPI Physical Medicine & Rehabilitation Physician · Olney, IL
NPI 1003452095 · NPPES record last updated Nov 25, 2019
Key facts
- NPI
- 1003452095
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Medicine & Rehabilitation Physician 208100000X
- License
- 160.004069 (IL)
- Practice address
- 800 E Locust St
Olney, IL 62450-2553 - Phone
- (618) 395-6031
- NPI assigned
- Nov 25, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 160.004069 | IL | MD | Physical Medicine & Rehabilitation Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | 160.004069 | IL | Yes |
Addresses
Primary practice location
800 E Locust St
Olney, IL 62450-2553
Mailing address
800 E Locust St
Olney, IL 62450-2553
Phone (618) 395-6031
Other providers in Olney, IL
- East Richland CSD 1
- Robert G Einhorn
- Emerald Glen of Olney
- Kelly S Eyer
- Thomas Falcone
- Yekaterina Fayn
- Feddes Chiropractic LTD
- Tara Feddes
- Fergs Quietude Inc
- Emily J Ferguson
All providers in Olney, IL · Physical Medicine & Rehabilitation Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 25, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.