Individual provider Active NPI

Michele K Loesche, PT

  • Physical Therapist
  • Waterloo, IL
National Provider Identifier
1609909563
Registry record updated Aug 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070010228 Issued in IL
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

Updated by the provider on Aug 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
070010228ILMDPhysical Therapist
113391MOMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wonder Works Pediatric Therapy P.C. Physical Therapist CurrentSince Aug 17, 2025 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.

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.

Verify at the official NPI Registry.