City Center Physical Therapy - Peru, Inc.
Organization Active NPI Physical Therapist · Peru, IL
NPI 1043362965 · NPPES record last updated Mar 25, 2009
Key facts
- NPI
- 1043362965
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- Legal business name
- CITY CENTER PHYSICAL THERAPY - PERU, INC.
- Practice address
- 1627 4TH St
Peru, IL 61354-3507 - Phone
- (815) 223-4479
- Fax
- (815) 223-4489
- NPI assigned
- Jan 18, 2007
- Organization subpart
- No
Authorized official
- Name
- Mr. Timothy R Semlow, PT
- Title
- Physical Therapist
- Phone
- (815) 722-1757
Practitioners 12
-
Eric S Bihl, PT
-
Kelsey Janelle Brannan, M.S., ATC
-
Steve Korsan, MS, ATC
-
Nicholas Medema, DPT
-
Trevor Samolinski, LAT
-
Timothy R Semlow, PT
-
Kory David Tieman, PT, DPT
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | IL | Yes |
Addresses
Primary practice location
1627 4TH St
Peru, IL 61354-3507
Mailing address
1627 4TH St
Peru, IL 61354-3507
Phone (815) 223-4479
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 211359 | Medicaid | IL | |
| 05032048 | Other | IL | BLUE CROSS BLUE SHIELD |
| DO3556 | Other | RRMC |
Other providers in Peru, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 25, 2009. 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.