| Jenelle Deatherage, PT | |
|
9901 N Knoxville Ave, Ste D, Peoria, IL 61615-1429 | |
| (309) 243-1989 | |
| Not Available |
| Full Name | Jenelle Deatherage |
|---|---|
| Gender | Female |
| Speciality | Physical Therapist |
| Location | 9901 N Knoxville Ave, Peoria, Illinois |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720090830 | NPI | - | NPPES |
| 070020706 | Other | IL | ILLINOIS PT LICENSE NO. |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 7357 (Minnesota) | Secondary |
| 225100000X | Physical Therapist | 070020706 (Illinois) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Jenelle Deatherage, PT 850 43rd Ave Ste 100, Moline, IL 61265-8401 Ph: (309) 743-2070 | Jenelle Deatherage, PT 9901 N Knoxville Ave, Ste D, Peoria, IL 61615-1429 Ph: (309) 243-1989 |
Michelle C Bayer, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2338 W Van Winkle Way, Suite 3100, Peoria, IL 61615 Phone: 309-693-9189 Fax: 309-693-9946 | |
Payton Hufnagel, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 6501 N Sheridan Rd, Peoria, IL 61614 Phone: 309-883-5070 | |
Jonathan R Sutter, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 309-655-4109 | |
Matthew Schultz, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 6501 N Sheridan Rd, Peoria, IL 61614 Phone: 309-621-4111 | |
Molly D Lisenby, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 5009 N Executive Dr Ste B, Peoria, IL 61614 Phone: 309-839-8631 Fax: 855-579-3536 | |
Vanessa L Halstead, PHYSICAL THERAPIST Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 507 E Armstrong Ave, Peoria, IL 61603 Phone: 309-686-1177 Fax: 309-687-2035 | |
Mrs. Theresa L. Snedden, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 6501 N Sheridan Rd, Peoria, IL 61614 Phone: 309-692-8110 |