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NPI Code Detail

MEDICARE: MRS. CHERYL JEANNE UY RUSHING PT

MEDICARE: MRS. CHERYL JEANNE UY RUSHING PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist70013948IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
170013948OTHERILPT LICENSE

General Provider Information

NPI Number : 1043296023
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CHERYL JEANNE UY RUSHING PT
Provider Business Mailing Address
First Line : 2205 DAKOTA LN
Second Line :
City : CENTRALIA
State : IL
Zip : 62801-8751
Country : US
Telephone Number : 618-292-2334
Fax Number :
Provider Business Practice Location Address
First Line : 8 DOCTORS PARK RD
Second Line :
City : MOUNT VERNON
State : IL
Zip : 62864-6224
Country : US
Telephone Number : 618-241-8595
Fax Number : 618-241-8759
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/21/2005
Last Update Date : 08/21/2012

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