MEDICARE: JERLINDA THOMAS PTA

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	225200000X	Physical Therapy Assistant	06003372A	IL

General Provider Information

NPI Number	:	1780500074
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JERLINDA THOMAS PTA

Provider Business Mailing Address
First Line	:	1040 BAYTOWNE DR APT 21
Second Line	:
City	:	CHAMPAIGN
State	:	IL
Zip	:	61822-7917
Country	:	US
Telephone Number	:	219-743-1994
Fax Number	:

Provider Business Practice Location Address
First Line	:	1040 BAYTOWNE DR APT 21
Second Line	:
City	:	CHAMPAIGN
State	:	IL
Zip	:	61822-7917
Country	:	US
Telephone Number	:	219-743-1994
Fax Number	:

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

Provider Enumeration Date	:	06/29/2026
Last Update Date	:	06/29/2026

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Directions to “ JERLINDA THOMAS PTA” Practice Location

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