Healthcare Provider Details

I. General information

NPI: 1811580327
Provider Name (Legal Business Name): COURTNEY L. CAVE DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2021
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 S CLAY AVE
JACKSONVILLE IL
62650-2937
US

IV. Provider business mailing address

420 S CLAY AVE
JACKSONVILLE IL
62650-2937
US

V. Phone/Fax

Practice location:
  • Phone: 217-414-0547
  • Fax:
Mailing address:
  • Phone: 217-528-7541
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070024724
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: