Janelle Moore, P.T.
Individual provider Active NPI Physical Therapist · Millstadt, IL
NPI 1790731404 · NPPES record last updated Oct 22, 2019
Key facts
- NPI
- 1790731404
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 70011977 (IL)
- Practice address
- 548 E Washington St
Millstadt, IL 62260-1283 - Phone
- (618) 476-9444
- NPI assigned
- May 25, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2000146676 | MO | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| FLS Physical Therapy Associates PC | Physical Therapist | Current |
Accepting new patients |
| Athletic and Therapeutic Institute of Bourbonnais, LLC | Physical Therapist | Current | Accepting new patients |
Locations
790 Remington Blvd
Bolingbrook, IL 60440
1275 N Convent St
Ste 3
Bourbonnais, IL 60914
Phone (815) 936-1855
4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001
880 Columbia Centre
Columbia, IL 62236
Phone (618) 281-9697
327 W Washington St
Millstadt, IL 62260
Phone (618) 476-9444
509 Hamacher St
Ste 101
Waterloo, IL 62298
Phone (618) 939-5555
109 W Geneva Rd
Wheaton, IL 60187
Phone (630) 784-3251
4418 Telegraph Rd
Saint Louis, MO 63129
Phone (314) 894-2222
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2000146676 | MO | |
| Physical Therapist | 225100000X | 70011977 | IL | Yes |
Addresses
Primary practice location
548 E Washington St
Millstadt, IL 62260-1283
Mailing address
790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2223
Other practice location 1
4418 Telegraph Rd
Oakville, MO 63129-3316
Phone (314) 894-2222
Other providers in Millstadt, IL
- Millstadt Ambulance Service
- Millstadt CCSD 160
- Millstadt Family Chiropractic, PC
- Millstadt Pharmacy
- Lauren Elizabeth Milton
- Crystal Michelle O'Donnell
- Kathleen Oliver
- Caralyn Hayley Pentland
- Amy Perez
- Positive Behavior Solutions, LLC
All providers in Millstadt, 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 Oct 22, 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.