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Individual
MICHAEL LAWRENCE PHILLIP
Active
Individual
MICHAEL LAWRENCE PHILLIP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
070015934
IL
225100000X
Physical Therapist
Primary
PTL.0012369
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1619908
BCBS IL GROUP
IL
01
—
567700
MEDICARE GROUP NUMBER
IL
01
—
568080
MEDICARE GROUP NUMBER
IL
01
—
568150
MEDICARE GROUP NUMBER
IL
01
—
CD3789
MEDICARE RAILROAD GROUP NUMBER
IL
01
—
P00624023
MEDICARE RAILROAD
IL
Enumeration date
08/31/2007
Last updated
03/29/2016
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