Norberto Valle Cruz, PT

Individual provider Active NPI Physical Therapist · Kewanee, IL

NPI 1235649658 · NPPES record last updated Oct 11, 2017

Key facts

NPI
1235649658
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
070.022842 (IL)
Practice address
144 Junior Ave
Kewanee, IL 61443-2554
Phone
(309) 853-4429
NPI assigned
Oct 11, 2017
Sex
Male
Sole proprietor
Yes

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)
No

State licenses

LicenseStateTypeSpecialty
070.022842ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Osf Healthcare System Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070.022842 IL Yes

Addresses

Primary practice location

144 Junior Ave
Kewanee, IL 61443-2554

Mailing address

440 W South St Apt E6
Kewanee, IL 61443-3682
Phone (309) 716-8496

Other providers in Kewanee, IL

All providers in Kewanee, IL · Physical Therapist in Illinois

Sources for this page

Verify at the official NPI Registry.