Individual
ANGELA L AUSILI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
2338 W SUD PKWY STE 3100, PEORIA, IL 61615-7482
(309) 693-9189
(309) 693-9946
Mailing address
2338 W SUD PKWY STE 3100, PEORIA, IL 61615-7482
(309) 693-9189
(309) 693-9946
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070-015408
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00931238
RR MEDICARE
IL
Enumeration date
12/20/2006
Last updated
07/08/2011
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