MEDICARE: MRS. LYNN ANN BABER 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
1	225100000X	Physical Therapist	070.005100	IL

General Provider Information

NPI Number	:	1316421985
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LYNN ANN BABER PT

Provider Business Mailing Address
First Line	:	12 FAIRWAY DR
Second Line	:
City	:	MONMOUTH
State	:	IL
Zip	:	61462-8692
Country	:	US
Telephone Number	:	309-221-1241
Fax Number	:

Provider Business Practice Location Address
First Line	:	117 S I ST
Second Line	:
City	:	MONMOUTH
State	:	IL
Zip	:	61462-1544
Country	:	US
Telephone Number	:	309-221-1241
Fax Number	:

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

Provider Enumeration Date	:	09/19/2018
Last Update Date	:	09/30/2018

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Directions to “ MRS. LYNN ANN BABER PT” Practice Location

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