MEDICARE: JULIE ENGELSDORFER LPMT, MT-BC

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	225A00000X	Music Therapist	144.000139	IL

General Provider Information

NPI Number	:	1720913155
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE ENGELSDORFER LPMT, MT-BC

Provider Business Mailing Address
First Line	:	915 E WALNUT ST
Second Line	:
City	:	BLOOMINGTON
State	:	IL
Zip	:	61701-3358
Country	:	US
Telephone Number	:	618-791-8143
Fax Number	:

Provider Business Practice Location Address
First Line	:	1100 BEECH ST BLDG 12-1
Second Line	:
City	:	NORMAL
State	:	IL
Zip	:	61761-1569
Country	:	US
Telephone Number	:	618-791-8143
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2026
Last Update Date	:	06/16/2026

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