Nancy L Connelly, P.T.
Individual provider Active NPI Physical Therapist · Red Bud, IL
NPI 1497092241 · NPPES record last updated Jan 14, 2013
Key facts
- NPI
- 1497092241
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 070007904 (IL)
- Practice address
- 325 Spring St
Red Bud, IL 62278-1105 - Phone
- (618) 282-5172
- Fax
- (618) 282-3596
- NPI assigned
- Jan 14, 2013
- 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 |
|---|---|---|---|
| 070007904 | IL | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070007904 | IL | Yes |
Addresses
Primary practice location
325 Spring St
Red Bud, IL 62278-1105
Mailing address
210 Rogers St
Waterloo, IL 62298-1597
Phone (618) 910-2709
Other providers in Red Bud, IL
- Comwell
- Comwell
- Comwell
- Comwell
- Comwell
- Cara Dake
- Margret De Jesus De Guzman
- De Wild Chiropractic Center, Inc
- Deaconess Illinois Clinic, Inc
- Deaconess Illinois Red Bud Regional Hospital Inc
All providers in Red Bud, 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 Jan 14, 2013. 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.