MEDICARE: LMT OF ILLINOIS, LLC

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
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1720300809
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LMT OF ILLINOIS, LLC

Provider Business Mailing Address
First Line	:	15 APEX DR
Second Line	:
City	:	HIGHLAND
State	:	IL
Zip	:	62249-1282
Country	:	US
Telephone Number	:	618-441-0482
Fax Number	:

Provider Business Practice Location Address
First Line	:	2323A OLD PLANK RD
Second Line	:
City	:	CHESTER
State	:	IL
Zip	:	62233-1153
Country	:	US
Telephone Number	:	618-441-0482
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RYAN LAMPE
Credential	:	PT
Telephone Number	:	618-441-0482

Provider Enumeration Date	:	02/17/2010
Last Update Date	:	11/20/2025

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