Basic Information
| Provider Information | |||||||||
| NPI: | 1649598384 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PROFESSIONAL THERAPY SERVICES, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 525 C. SWEETBRIAR DRIVE | ||||||||
| Address2: | |||||||||
| City: | CHILLICOTHE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 615232229 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3092746314 | ||||||||
| FaxNumber: | 3092744100 | ||||||||
| Practice Location | |||||||||
| Address1: | 525 C. SWEETBRIAR DRIVE | ||||||||
| Address2: | |||||||||
| City: | CHILLICOTHE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 615232229 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3092746314 | ||||||||
| FaxNumber: | 3092744100 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/05/2010 | ||||||||
| LastUpdateDate: | 02/22/2011 | ||||||||
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| AuthorizedOfficialLastName: | RILEY | ||||||||
| AuthorizedOfficialFirstName: | MICHAEL | ||||||||
| AuthorizedOfficialMiddleName: | R | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6182349705 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | PROFESSIONAL THERAPY SERVICES, INC. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | N | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | 235Z00000X | N | 193200000X MULTI-SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | 225100000X | Y | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.