Organization
COBBLESTONE REHABILITATION, L.P.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBIN SPALDING (DIRECTOR OF OPERATIONS)
(217) 366-0033
Entity
Organization
Contact information
Practice address
4102 BELMONT PT, CHAMPAIGN, IL 61822-3506
(217) 366-0033
(217) 366-0012
Mailing address
PO BOX 6694, CHAMPAIGN, IL 61826-6694
(217) 366-0033
(217) 366-0012
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
—
225100000X
Physical Therapist
—
—
225200000X
Physical Therapy Assistant
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01032020
BLUE CROSS BLUE SHIELD IL
IL
Enumeration date
02/01/2007
Last updated
09/04/2015
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