Mary Youmans, PTA
Individual provider Active NPI Physical Therapy Assistant · Gifford, IL
NPI 1982011433 · NPPES record last updated Jul 16, 2014
Key facts
- NPI
- 1982011433
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 160.005594 (IL)
- Practice address
- 2304 County Road 3000 N
Gifford, IL 61847-9756 - Phone
- (217) 568-7362
- Fax
- (217) 568-7314
- NPI assigned
- Jul 16, 2014
- 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 |
|---|---|---|---|
| 160.005594 | IL | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 160.005594 | IL | Yes |
Addresses
Primary practice location
2304 County Road 3000 N
Gifford, IL 61847-9756
Mailing address
550 W Frontage Rd
Suite 2415
Northfield, IL 60093-1202
Phone (877) 787-2422
Other providers in Gifford, IL
All providers in Gifford, 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 Jul 16, 2014. 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.