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General NPI Number Information
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NPI Number | 1245332568
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Entity Type | Organization
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Legal Business Name | TLC OF SOUTHERN & CENTRAL ILLINOIS INC.
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Dates
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Enumeration Date | 09/05/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1703 POTEETE
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City | CARTERVILLE
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State | IL
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Zip | 62918-0364
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Country | US
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Telephone | 618-985-2181
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Fax | 618-985-6055
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Provider Business Mailing Address
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Address Line | PO BOX 364
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City | CARTERVILLE
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State | IL
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Zip | 62918-0364
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Country | US
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Telephone | 618-985-2181
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Fax | 618-985-6055
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | TOMMYE L ROBB
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Credential | CCC/SLP
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Telephone | 618-985-2181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number |
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License Number State | IL
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