Across All Ages Physical Therapy LLC

Organization Active NPI Physical Therapist · Breese, IL

NPI 1003521998 · NPPES record last updated May 26, 2023

Key facts

NPI
1003521998
Entity type
Organization (NPI type 2)
Primary specialty
Physical Therapist 225100000X
Legal business name
ACROSS ALL AGES PHYSICAL THERAPY LLC
Practice address
380 S Germantown Rd
Breese, IL 62230-2088
Phone
(618) 526-9311
Fax
(877) 420-7862
NPI assigned
Jan 16, 2023
Organization subpart
No

Authorized official

Name
Margaret Timmermann, PT
Title
Owner
Phone
(618) 526-9311

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20230225000425 IL Part B Supplier - Clinic/Group Practice 8628441425 Receives reassigned benefits from 1 practitioner
Practice locations: Breese, IL

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist
Group: 193400000X SINGLE SPECIALTY GROUP
225100000X Yes
Occupational Therapist
Group: 193200000X MULTI-SPECIALTY GROUP
225X00000X

Addresses

Primary practice location

380 S Germantown Rd
Breese, IL 62230-2088

Mailing address

380 S Germantown Rd
Breese, IL 62230-2088
Phone (618) 526-9322

Other providers in Breese, IL

All providers in Breese, IL · Physical Therapist in Illinois

Sources for this page

Verify at the official NPI Registry.