Active NPI
Michele K Loesche, PT
- Physical Therapist
- Waterloo, IL
National Provider Identifier
1609909563
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070010228
- Practice address
- 706 Rogers St
Waterloo, IL 62298-1780 - Phone
- (618) 939-7761
- Fax
- (855) 606-6318
- NPI assigned
- Mar 13, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 113391 | MO | |
| Physical Therapist | 225100000X | 070010228 | IL | Primary |
Addresses
Primary practice location
706 Rogers St
Waterloo, IL 62298-1780
Mailing address
706 Rogers St
Waterloo, IL 62298-1780
Phone (618) 939-7761
Other practice location 1
12110 Clayton Rd
Saint Louis, MO 63131-2516
Phone (314) 989-8150
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070010228 | IL | MD | Physical Therapist |
| 113391 | MO | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wonder Works Pediatric Therapy P.C. | Physical Therapist | Current | Accepting new patients |
| Special School District of St. Louis County | Past | Accepting new patients |
Locations
706 Rogers St
Waterloo, IL 62298
Phone (618) 939-7761
Organizations & group practices 2
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.
-
- Speech-Language Pathologist
- Waterloo, IL
- NPI 1649022518
Physical Therapist
-
- Local Education Agency (LEA)
- Saint Louis, MO
- NPI 1922128354
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755129600000",
"number": "1609909563",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "706 ROGERS ST",
"city": "WATERLOO",
"state": "IL",
"postal_code": "622981780",
"telephone_number": "618-939-7761",
"fax_number": "855-606-6318"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "706 ROGERS ST",
"city": "WATERLOO",
"state": "IL",
"postal_code": "622981780",
"telephone_number": "618-939-7761",
"fax_number": "855-606-6318"
}
],
"practiceLocations": [
{
"address_1": "12110 Clayton Rd",
"address_purpose": "LOCATION",
"city": "Saint Louis",
"state": "MO",
"postal_code": "631312516",
"country_code": "US",
"telephone_number": "314-989-8150",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LOESCHE",
"first_name": "MICHELE",
"middle_name": "K",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-13",
"last_updated": "2025-08-14",
"certification_date": "2025-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "113391",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070010228",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Waterloo, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 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.