Konner Sloane Street, DPT in Maryville, IL - Medicare Physical Therapist Provider

Konner Sloane Street, DPT is a medicare enrolled "Physical Therapist" provider in Maryville, Illinois. Her current practice location is 6800 State Route 162, Maryville, Illinois. You can reach out to her office (for appointments etc.) via phone at (618) 288-5711.

Konner Sloane Street is licensed to practice in Illinois (license number 070.029219) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1780453308.

Contact Information

	Konner Sloane Street, DPT
	6800 State Route 162, Maryville, IL 62062
	(618) 288-5711
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Konner Sloane Street
Gender	Female
Speciality	Physical Therapist
Location	6800 State Route 162, Maryville, Illinois
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1780453308
Provider Enumeration Date: 12/22/2023
Last Update Date: 08/27/2025

Medicare PECOS Information:

PECOS PAC ID: 6507305943
Enrollment ID: I20240828005192

Medical Identifiers

Medical identifiers for Konner Sloane Street such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1780453308	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225100000X	Physical Therapist	008995 (Kentucky)	Secondary
2251P0200X	Physical Therapist - Pediatrics	008995 (Kentucky)	Secondary
225100000X	Physical Therapist	070.029219 (Illinois)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Konner Sloane Street allows following entities to bill medicare on her behalf.

Provider Name	Redwood School & Rehabilitation Center, Inc.
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1568732758 PECOS PAC ID: 0042383937 Enrollment ID: O20191009002871

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Konner Sloane Street is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Konner Sloane Street, DPT 6800 State Route 162, Maryville, IL 62062-8500 Ph: (618) 288-5711	Konner Sloane Street, DPT 6800 State Route 162, Maryville, IL 62062 Ph: (618) 288-5711

Reviews and Comments

Physical Therapist in Maryville, IL

Mary Vaughn, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 6800 State Route 162, Maryville, IL 62062 Phone: 618-288-5711 Fax: 618-288-4088
Anna Mcnamara, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 6800 State Route 162, Maryville, IL 62062 Phone: 618-288-5436 Fax: 618-288-5567
Diane A. Richter, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 6800 State Route 162, Maryville, IL 62062 Phone: 618-288-5711 Fax: 618-288-4088
Sarah L. Helle, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 6800 State Route 162, Maryville, IL 62062 Phone: 618-288-5711 Fax: 618-288-4088
Federico Morta David, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2928 N. Center St., Maryville, IL 62062 Phone: 618-288-5711
Alisha Wilken, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 6800 State Route 162, Maryville, IL 62062 Phone: 618-288-5711 Fax: 618-288-4088
Whitney Nichols, DOCTOR Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 2023 Vadalabene Dr Ste 300, Maryville, IL 62062 Phone: 618-288-6722

Konner Sloane Street, DPT - Medicare Physical Therapist in Maryville, IL