Azer III, P.C.
Organization Active NPI Physical Therapist · Galesburg, IL
NPI 1407948748 · NPPES record last updated Mar 16, 2023
Key facts
- NPI
- 1407948748
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- Legal business name
- AZER III, P.C.
- Practice address
- 872 W Dayton St
Galesburg, IL 61401-1503 - Phone
- (309) 344-3400
- Fax
- (309) 344-5040
- NPI assigned
- Sep 28, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Fakhry Wilson Azer, P.T.
- Title
- President
- Phone
- (309) 344-3400
Practitioners 2
-
Fakhry Wilson Azer, P.T.
-
Melissa Engebretson, P.T.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060306000209 | IL | Part a Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services | 5799791497 | Practice locations: Galesburg, IL |
National Provider Directory
Locations
1470 N Henderson St
Galesburg, IL 61401
Phone (309) 344-3402
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | Yes | ||
| Geriatric Physical Therapist |
2251G0304X | |||
| Occupational Therapist |
225X00000X | |||
| Speech-Language Pathologist |
235Z00000X |
Addresses
Primary practice location
872 W Dayton St
Galesburg, IL 61401-1503
Mailing address
872 W Dayton St
Galesburg, IL 61401-1503
Phone (309) 344-3400
Other names
- Azer Clinic
Other providers in Galesburg, IL
- Linda M Auer
- Ava Rose Eyecare LTD
- Susie Marie Avery
- Chris M Ayers
- Robert Ayers
- Azer Medical Supply, Inc.
- Azer Rehab Systems, P.C.
- Fakhry Wilson Azer
- Tiffany Marie Babcock
- Lynn Bachelder
All providers in Galesburg, 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 Mar 16, 2023. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.