Reid Baltikauski, DPT
Individual provider Active NPI Physical Therapist · Mendota, IL
NPI 1629404157 · NPPES record last updated Sep 16, 2013
Key facts
- NPI
- 1629404157
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 070020075 (IL)
- Practice address
- 1401 E 12TH St
Mendota, IL 61342-9216 - Phone
- (815) 539-1409
- NPI assigned
- Sep 16, 2013
- Sex
- Male
- 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 |
|---|---|---|---|
| 070020075 | IL | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070020075 | IL | Yes |
Addresses
Primary practice location
1401 E 12TH St
Mendota, IL 61342-9216
Mailing address
1401 E 12TH St
Mendota, IL 61342-9216
Phone (815) 539-1409
Other providers in Mendota, IL
- American Lutheran Church Mendota
- Associated Physicians, SC
- Abdul Moyeed Atif
- Richard Jospeh Baker
- Balanced Family Chiropractic LTD
- Juli Renee Barrett Leifheit
- Cynthia A. Becker
- Atalia Bernabe
- Kristen Marie Beversdorf
- Bhate & Bhate Radiology LTD.
All providers in Mendota, 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 Sep 16, 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.