Brenda Leisinger, PT

Individual provider Active NPI Physical Therapist · Channahon, IL

NPI 1235295486 · NPPES record last updated Aug 14, 2013

Key facts

NPI
1235295486
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
070-002625 (IL)
Practice address
25445 S Pheasant LN
Unit H
Channahon, IL 60410-8838
Phone
(815) 521-0111
Fax
(815) 521-0222
NPI assigned
Dec 29, 2006
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
070-002625ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Newsome Rehabilitation Center Physical Therapist Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070-002625 IL Yes

Addresses

Primary practice location

25445 S Pheasant LN
Unit H
Channahon, IL 60410-8838

Mailing address

205 W Wacker Dr
Suite 1020
Chicago, IL 60606-1216
Phone (312) 640-0329

Other providers in Channahon, IL

All providers in Channahon, IL · Physical Therapist in Illinois

Sources for this page

Verify at the official NPI Registry.