Amanda K Kocis, DPT

Individual provider Active NPI Physical Therapist · Kewanee, IL

NPI 1144530981 · NPPES record last updated Jun 14, 2012

Key facts

NPI
1144530981
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
070-014532 (IL)
Practice address
1 Pine Tree CT
Kewanee, IL 61443-9600
Phone
(309) 540-9895
NPI assigned
Oct 14, 2010
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

LicenseStateTypeSpecialty
070-014532ILMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070-014532 IL Yes

Addresses

Primary practice location

1 Pine Tree CT
Kewanee, IL 61443-9600

Mailing address

1051 W South St
PO Box 747
Kewanee, IL 61443-8354
Phone (309) 852-7500

Other identifiers

IdentifierTypeStateIssuer
070-014532OtherILIL LICENSE NO

Other providers in Kewanee, IL

All providers in Kewanee, IL · Physical Therapist in Illinois

Sources for this page

Verify at the official NPI Registry.