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NPI Code Detail

MEDICARE: MR. STEVEN T THORP PT

MEDICARE:  MR. STEVEN T THORP  PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistIL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
17216OTHERPERSONALCARE PROV ID
2113326OTHERHEALTHLINK PROV ID
3203OTHERILBLUE CROSS PROV ID
44117OTHERILHAMP PROV ID

General Provider Information

NPI Number : 1104943091
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. STEVEN T THORP PT
Provider Business Mailing Address
First Line : 611 W PARK ST
Second Line :
City : URBANA
State : IL
Zip : 61801-2500
Country : US
Telephone Number : 217-326-2911
Fax Number : 217-344-8047
Provider Business Practice Location Address
First Line : 1504 EAST GROVE
Second Line :
City : RANTOUL
State : IL
Zip : 61866-2736
Country : US
Telephone Number : 217-893-7720
Fax Number : 217-893-7803
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2007
Last Update Date : 07/08/2007

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Directions to “ MR. STEVEN T THORP PT” Practice Location

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