Healthcare Provider Details

I. General information

NPI: 1992628150
Provider Name (Legal Business Name): THE SUN ROOM INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 N DIRKSEN PKWY
SPRINGFIELD IL
62702-6196
US

IV. Provider business mailing address

3219 E CARPENTER ST
SPRINGFIELD IL
62702-6201
US

V. Phone/Fax

Practice location:
  • Phone: 217-241-8300
  • Fax:
Mailing address:
  • Phone: 217-241-8300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: TERRI WALKER
Title or Position: PRESIDENT
Credential:
Phone: 217-241-8300