Elise Marie Anderson, LPTA
Individual provider Active NPI Physical Therapy Assistant · Lincoln, IL
NPI 1154538007 · NPPES record last updated Jun 13, 2012
Key facts
- NPI
- 1154538007
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 160-000990 (KS)
- Practice address
- 200 Stahlhut Dr
Lincoln, IL 62656-5066 - Phone
- (217) 605-5503
- NPI assigned
- May 17, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 160-000990 | KS | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 160-000990 | KS | Yes |
Addresses
Primary practice location
200 Stahlhut Dr
Lincoln, IL 62656-5066
Mailing address
217 N Gillett St
Elkhart, IL 62634-6002
Phone (217) 415-6893
Other providers in Lincoln, IL
- Frank Adubato
- Aegis Group Practice LLC
- Carrie Goodrum Alexander
- Darwin J Allen
- Alpha Omega Consulting, Inc.
- Arc at Lincoln LLC
- Arc at Lincoln LLC
- Norine Ella Ashley
- Edmund Au
- Amy Irene Bailey
All providers in Lincoln, IL · Physical Therapy Assistant in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 13, 2012. 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.