MEDICARE: HOLLY LYNN ABELL

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
1	225100000X	Physical Therapist	070.023128	IL

General Provider Information

NPI Number	:	1134647902
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOLLY LYNN ABELL

Provider Business Mailing Address
First Line	:	139 STONEBRIAR DR
Second Line	:
City	:	TROY
State	:	IL
Zip	:	62294-1752
Country	:	US
Telephone Number	:	618-830-7195
Fax Number	:

Provider Business Practice Location Address
First Line	:	3354 JEROME LN
Second Line	:
City	:	CAHOKIA
State	:	IL
Zip	:	62206-2604
Country	:	US
Telephone Number	:	618-337-9400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2017
Last Update Date	:	07/15/2025

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