Brooke Hayley Bishop, PTA
Individual provider Active NPI Physical Therapy Assistant · Chrisman, IL
NPI 1417119504 · NPPES record last updated Jun 30, 2008
Key facts
- NPI
- 1417119504
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 160004229 (IL)
- Practice address
- 400 W Washington Ave
Chrisman, IL 61924-1042 - Phone
- (217) 269-2105
- Fax
- (217) 269-2108
- NPI assigned
- Jun 30, 2008
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 160004229 | IL | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 160004229 | IL | Yes |
Addresses
Primary practice location
400 W Washington Ave
Chrisman, IL 61924-1042
Mailing address
1208 Berry St
Dennison, IL 62423-2109
Phone (217) 463-2572
Other providers in Chrisman, IL
- Jill Ellen Bosch
- Chrisman Dental Care PC
- Christian Homes, Inc.
- Christian Homes, Inc.
- Christian Homes, Inc.
All providers in Chrisman, IL · Physical Therapy Assistant in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 30, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.