Healthcare Provider Details

I. General information

NPI: 1033971940
Provider Name (Legal Business Name): ANNA STREENZ PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNA HARTZLER PT

II. Dates (important events)

Enumeration Date: 01/25/2024
Last Update Date: 01/25/2024
Certification Date: 01/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 CARVER LN
EAST PEORIA IL
61611-3052
US

IV. Provider business mailing address

148 JAY AVE
MORTON IL
61550-1302
US

V. Phone/Fax

Practice location:
  • Phone: 309-282-6704
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT019909
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070027507
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: