MEDICARE: ERIC J BADER 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	070014079	IL

General Provider Information

NPI Number	:	1730271735
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIC J BADER PT

Provider Business Mailing Address
First Line	:	421 W EXCHANGE ST
Second Line	:
City	:	FREEPORT
State	:	IL
Zip	:	61032-4008
Country	:	US
Telephone Number	:	815-599-7958
Fax Number	:

Provider Business Practice Location Address
First Line	:	1120 HEALTHCARE DR
Second Line	:
City	:	MOUNT CARROLL
State	:	IL
Zip	:	61053-1461
Country	:	US
Telephone Number	:	815-244-4181
Fax Number	:

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

Provider Enumeration Date	:	09/28/2006
Last Update Date	:	05/22/2026

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