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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