Bernadette S Petalber, LPT
Individual provider Active NPI Physical Therapist · Cherry Valley, IL
NPI 1326152018 · NPPES record last updated Apr 3, 2012
Key facts
- NPI
- 1326152018
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 070011203 (IL)
- Practice address
- 1860 S Bell School Rd
Cherry Valley, IL 61016-9372 - Phone
- (815) 580-8270
- Fax
- (815) 580-8278
- NPI assigned
- Aug 18, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Optimum Rehabilitation and Chiropractic, LTD
Practice addresses (Care Compare)
1860 S Bell School Rd
Cherry Valley, IL 61016-9372
Phone (815) 580-8270
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040923000205 | IL | Practitioner - Physical Therapist in Private Practice | 9931177326 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070011203 | IL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Optimum Rehabilitation and Chiropractic, LTD. | Physical Therapist | Current |
Accepting new patients |
| Medchoice Medical Center LTD | Physical Therapist | Past |
Accepting new patients |
Locations
1860 S Bell School Rd
Cherry Valley, IL 61016
Phone (815) 580-8270
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070011203 | IL | Yes |
Addresses
Primary practice location
1860 S Bell School Rd
Cherry Valley, IL 61016-9372
Mailing address
1860 S Bell School Rd
Cherry Valley, IL 61016-9372
Phone (815) 580-8270
Other providers in Cherry Valley, IL
- Jessey Mathew
- Mo Chara Hospice LLC
- Racheal Rene Morse
- Richard R. Olson
- Optimum Rehabilitation and Chiropractic, LTD.
- Megan Rankin
- Maria P Rodriguez
- Joseph Michael Schoening
- Sparrow Hope Counseling PLLC
- Joseph Stoyas
All providers in Cherry Valley, IL · Physical Therapist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 3, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.