Nicholas Hentis

Individual provider Active NPI Physical Therapist · Chester, IL

NPI 1669736724 · NPPES record last updated Jul 3, 2012

Key facts

NPI
1669736724
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
070.018968 (IL)
Practice address
1900 State St
Chester, IL 62233-1116
Phone
(618) 826-4581
NPI assigned
Jul 3, 2012
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

LicenseStateTypeSpecialty
070.018968ILMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070.018968 IL Yes

Addresses

Primary practice location

1900 State St
Chester, IL 62233-1116

Mailing address

1900 State St
Chester, IL 62233-1116

Other providers in Chester, IL

All providers in Chester, IL · Physical Therapist in Illinois

Sources for this page

Verify at the official NPI Registry.