Toni Marie Lais, P.T.

Individual provider Active NPI Physical Therapist · Eureka, IL

NPI 1821395773 · NPPES record last updated Mar 12, 2013

Key facts

NPI
1821395773
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
070.017501 (IL)
Practice address
120 N Main St
Eureka, IL 61530-1182
Phone
(309) 467-3220
Fax
(309) 467-3240
NPI assigned
Feb 11, 2011
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
070.017501ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Illinois Institute of Balance LLC Physical Therapist Past
since Mar 15, 2007
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070.017501 IL Yes

Addresses

Primary practice location

120 N Main St
Eureka, IL 61530-1182

Mailing address

120 N Main St
Eureka, IL 61530-1182
Phone (309) 467-3220

Other providers in Eureka, IL

All providers in Eureka, IL · Physical Therapist in Illinois

Sources for this page

Verify at the official NPI Registry.