James Allan Berg Jr., P.T.

Individual provider Active NPI Physical Therapist · Galesburg, IL

NPI 1750528600 · NPPES record last updated Jan 14, 2009

Key facts

NPI
1750528600
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
070014492 (IL)
Practice address
280 E Losey St
Galesburg, IL 61401-2819
Phone
(309) 343-2166
NPI assigned
Jan 14, 2009
Sex
Male
Sole proprietor
Yes

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
03314IAMDPhysical Therapist
070014492ILMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070014492 IL Yes
Physical Therapist 225100000X 03314 IA

Addresses

Primary practice location

280 E Losey St
Galesburg, IL 61401-2819

Mailing address

902 Iowa Dr
Le Claire, IA 52753-9814
Phone (563) 289-1349

Other providers in Galesburg, IL

All providers in Galesburg, IL · Physical Therapist in Illinois

Sources for this page

Verify at the official NPI Registry.