Individual
ANN E BASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
2351 BROADWAY ST, PEKIN, IL 61554-3972
(309) 353-5940
(309) 353-1654
Mailing address
2351 BROADWAY ST, PEKIN, IL 61554-3972
(309) 353-5940
(309) 353-1654
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070005659
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00153845
RR MEDICARE PTAN
IL
Enumeration date
03/27/2007
Last updated
05/27/2011
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