Individual
MR. BART M TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
301 EAST SOUTHLINE RD, TUSCOLA, IL 61953
(217) 253-3426
(217) 253-2268
Mailing address
611 W. PARK, URBANA, IL 61801-2500
(217) 326-2911
(217) 344-8047
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
70016016
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
113326
HEALTHLINK PROVIDER #
IL
01
—
203
BLUE CROSS
IL
01
—
4117
HAMP PROVIDER #
IL
01
—
7216
PERSONAL CARE PROVIDER #
IL
Enumeration date
09/25/2007
Last updated
09/25/2007
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