Sean Michael Koller, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070027949 Issued in IL

Practice address

3100 S Park Ave
Herrin, IL 62948-3720

Phone

(618) 993-4024

NPI assigned

Aug 29, 2025

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Southern Illinois Hospital Services

  • Physical Therapy Clinic/Center
  • Herrin, IL
  • NPI 1285540427
  NPD (past)
• Southern Illinois Hospital Services

  • Medicare Defined Swing Bed Hospital Unit
  • Murphysboro, IL
  • NPI 1639595036
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1756425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756425600000",
    "number": "1386523769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 S PARK AVE",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "629483720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 S PARK AVE",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "629483720",
            "telephone_number": "618-993-4024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLLER",
        "first_name": "SEAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-08-29",
        "last_updated": "2025-08-29",
        "certification_date": "2025-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070027949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dena Leigh Kirk, OTR/L
• Katherine Jo Kleckner, RPH
• Koen Counseling and Wellness Center
• Nina Kaye Koen, DSW, LCSW, MSW
• Abhish Koirala, M.D.
• Mark J Korte, M.D.
• Antoni J Kos, MD
• Rebekah Marie Kosco
• Brittany Rachelle Kramer, NP
• Brianna Nicole Krelo

• Physical Therapist in Herrin, IL
• Providers in Herrin, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.