Individual
ANTHONY SCHUPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
209 N CUMMINGS LN, WASHINGTON, IL 61571-2181
(309) 886-2305
(309) 444-3893
Mailing address
209 N CUMMINGS LN, WASHINGTON, IL 61571-2181
(309) 886-2305
(309) 444-3893
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070016473
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00918646
RR MEDICARE PTAN
IL
Enumeration date
07/08/2008
Last updated
05/27/2011
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