West Central Illinois Therapy & Sports Medicine Center, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

WEST CENTRAL ILLINOIS THERAPY & SPORTS MEDICINE CENTER, LLC

Practice address

128 W Washington St
Pittsfield, IL 62363-1441

Phone

(217) 285-4512

Fax

(217) 285-5740

NPI assigned

Jan 17, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Dan Evans, MD

Title

Chairman of the Board

Phone

(217) 222-6550

Specialties & licenses 2

Addresses

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Blessingcare Corporation

  • Emergency Medicine Physician
  • Pittsfield, IL
  • NPI 1992038640

  Member Of

  NPD member
• Quincy Physicians & Surgeons Clinic, PLLC

  • Ambulatory Surgical Clinic/Center
  • Quincy, IL
  • NPI 1245862002

  Member Of

  NPD member

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199836800000",
    "number": "1881746097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 MAINE ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623014038",
            "telephone_number": "217-222-6550",
            "fax_number": "217-277-2253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 W WASHINGTON ST",
            "city": "PITTSFIELD",
            "state": "IL",
            "postal_code": "623631441",
            "telephone_number": "217-285-4512",
            "fax_number": "217-285-5740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST CENTRAL ILLINOIS THERAPY & SPORTS MEDICINE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2008-01-09",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "DAN",
        "authorized_official_title_or_position": "CHAIRMAN OF THE BOARD",
        "authorized_official_telephone_number": "217-222-6550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Unlimited Development Inc.
• Tina Marie Veile, ATC
• Wal-Mart Stores, Inc
• Ashley Renee Walker, FNP-BC
• Walmart Inc.
• Laura Leanne West
• Douglas Jack White, D.M.D.
• Sherri Renee White, MSN, AGNP-C
• Edwina Lynn Wilber, NP
• Rebecca L. Williams

• All providers in Pittsfield, IL
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.