Jean Marie Prekop, P.T.

Individual provider Active NPI Physical Therapist · New Berlin, WI

NPI 1154493716 · NPPES record last updated Jul 9, 2007

Key facts

NPI
1154493716
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
2048-024 (WI)
Practice address
2895 S Moorland Rd
New Berlin, WI 53151-3743
Phone
(262) 782-9015
Fax
(262) 782-9013
NPI assigned
Nov 15, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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
2048-024WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Injury Rehabilitation Clinic II, Inc. Physical Therapist Past
since Jan 1, 2000
Accepting new patients
Curative New Berlin Therapies, LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2048-024 WI Yes

Addresses

Primary practice location

2895 S Moorland Rd
New Berlin, WI 53151-3743

Mailing address

S85W17850 Woods Rd
Muskego, WI 53150-9454
Phone (262) 679-8998

Other identifiers

IdentifierTypeStateIssuer
40058500MedicaidWI

Other providers in New Berlin, WI

All providers in New Berlin, WI · Physical Therapist in Wisconsin

Sources for this page

Verify at the official NPI Registry.