Bonnie Jean Lampe, PTA
Individual provider Active NPI Physical Therapy Assistant · O'Fallon, IL
NPI 1780144808 · NPPES record last updated Mar 24, 2019
Key facts
- NPI
- 1780144808
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 160004212 (IL)
- Practice address
- 316 Donna Dr
O'Fallon, IL 62269 - Phone
- (618) 660-8686
- NPI assigned
- Mar 24, 2019
- Sex
- Female
- 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 |
|---|---|---|---|
| 160004212 | IL | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 160004212 | IL | Yes |
Addresses
Primary practice location
316 Donna Dr
O'Fallon, IL 62269
Mailing address
316 Donna Dr
O'Fallon, IL 62269
Phone (618) 660-8686
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | bj327@sbcglobal.net |
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All providers in O'Fallon, IL · Physical Therapy Assistant in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 24, 2019. 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.