Organization
CENTRAL ILLINOIS PHYSICAL THERAPY PROFESSIONALS, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD WARREN KRUCKEBERG PT (OWNER)
(217) 345-1245
Entity
Organization
Contact information
Practice address
2 E HARRISON ST, SULLIVAN, IL 61951-1905
(217) 345-1245
(217) 345-1253
Mailing address
PO BOX 101, SULLIVAN, IL 61951-0101
(217) 345-1245
(855) 509-0425
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070002766
IL
Other
Enumeration date
04/24/2007
Last updated
12/10/2025
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