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NPI Code Detail

MEDICARE: JEFFREY DYKE P.T.

MEDICARE: JEFFREY DYKE P.T.
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 Therapist070005368IL

General Provider Information

NPI Number : 1316029879
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY DYKE P.T.
Provider Business Mailing Address
First Line : 101 E MILLER RD
Second Line :
City : STERLING
State : IL
Zip : 61081-1252
Country : US
Telephone Number : 815-625-4790
Fax Number :
Provider Business Practice Location Address
First Line : 1809 LOCUST ST
Second Line :
City : STERLING
State : IL
Zip : 61081-1101
Country : US
Telephone Number : 815-625-4790
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2006
Last Update Date : 04/25/2013

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Directions to “ JEFFREY DYKE P.T.” Practice Location

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