Katie L Adams, OTD, OTR/L

Individual provider Active NPI Physical Medicine & Rehabilitation Physician · Normal, IL

NPI 1134338940 · NPPES record last updated Oct 10, 2011

Key facts

NPI
1134338940
Entity type
Individual (NPI type 1)
Primary specialty
Physical Medicine & Rehabilitation Physician 208100000X
License
056008051 (IL)
Practice address
2200 Fort Jesse Rd
Suite 250
Normal, IL 61761-6286
Phone
(309) 454-1616
Fax
(309) 454-5167
NPI assigned
May 21, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
056008051ILMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic & Sports Medicine Center Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 056008051 IL Yes

Addresses

Primary practice location

2200 Fort Jesse Rd
Suite 250
Normal, IL 61761-6286

Mailing address

2200 Fort Jesse Rd
Suite 250
Normal, IL 61761-6286
Phone (309) 268-0000

Other providers in Normal, IL

All providers in Normal, IL · Physical Medicine & Rehabilitation Physician in Illinois

Sources for this page

Verify at the official NPI Registry.