Rachel Marie Komeshak, PT
Individual provider Active NPI Physical Therapist · O'Fallon, IL
NPI 1821112640 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1821112640
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- Practice address
- 705 W Hwy 50
O'Fallon, IL 62269 - Phone
- (618) 624-4242
- Fax
- (618) 624-5127
- NPI assigned
- Mar 19, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
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 |
|---|---|---|---|
| 070.014685 | IL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Midwest Spine and Rehab Corp | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | IL | Yes |
Addresses
Primary practice location
705 W Hwy 50
O'Fallon, IL 62269
Mailing address
779 Merrifields Dr
O Fallon, IL 62269-6954
Phone (865) 216-7880
Other providers in O'Fallon, IL
- Integrated Medical Group, LTD
- Cassie Marie Ishmael
- Amy Lynn Katsikas
- Laura Knuf
- Pawelle Kole
- Sakshi Lakhra
- Bonnie Jean Lampe
- Lifetime Dental Care of Illinois, PC
- Lifetime Dental Care of Illinois, PC
- Mark Lewis Madder
All providers in O'Fallon, 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 Jul 8, 2007. 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.