Physician Compare National (NPI:1457879256)

HEALTHCARE PROVIDER: LORI LEIGH GRAN PHYSICAL THERAPIST

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1457879256
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4587923651
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20180117002669
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	GRAN
	Individual professional last name
Provider First Name	LORI
	Individual professional first name
Provider Middle Name	LEIGH
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF TENNESSEE, HSC, COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	1990
	Individual professional's medical school graduation year
Primary Specialty	PHYSICAL THERAPY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	EMPOWERME REHABILITATION ILLINOIS LLC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	2365718277
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	37
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	7108 MARINE RD
	Group Practice or individual's line 1 address
City	EDWARDSVILLE
	Group Practice or individual's city
State	IL
	Group Practice or individual's state
Zip Code	620254282
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3144857979
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	M