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Organization
ADVANCED REHAB SPORTS MEDICINE
Active
Organization
ADVANCED REHAB SPORTS MEDICINE
Active
Other names
Advanced Rehab Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MARK STEVEN OERTWIG (DIRECTOR OF FINANCE)
(309) 661-8823
Entity
Organization
Contact information
Practice address
1201 E BROADWAY, SUITE C, MONMOUTH, IL 61462-1994
(309) 734-1103
(309) 734-2013
Mailing address
PO BOX 5387, BLOOMINGTON, IL 61702-5387
(309) 661-8823
(309) 661-8801
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
IL
225X00000X
Occupational Therapist
—
IL
235Z00000X
Speech-Language Pathologist
—
IL
Other
Enumeration date
08/16/2005
Last updated
11/03/2022
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