| Prajakta Kudalkar, PT | |
|
1241 E Main St, Carbondale, IL 62901-3149 | |
| (618) 529-0516 | |
| (618) 529-0403 |
| Full Name | Prajakta Kudalkar |
|---|---|
| Gender | Female |
| Speciality | Physical Therapist |
| Location | 1241 E Main St, Carbondale, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720660525 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 14808-24 (Wisconsin) | Secondary |
| 225100000X | Physical Therapist | 070.025054 (Illinois) | Primary |
| Provider Name | Pleasanton Physical Therapy Services Inc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1336295138 PECOS PAC ID: 4284690694 Enrollment ID: O20041207001260 |
| Mailing Address | Practice Location Address |
|---|---|
| Prajakta Kudalkar, PT 1200 Black Diamond Dr Apt 8, Carbondale, IL 62901-5168 Ph: (269) 276-6542 | Prajakta Kudalkar, PT 1241 E Main St, Carbondale, IL 62901-3149 Ph: (618) 529-0516 |
Dr. Steve Middleton, PT, DPT, ATC Physical Therapist Medicare: Medicare Enrolled Practice Location: 100 S Glenview Dr, Carbondale, IL 62901 Phone: 618-559-8196 | |
Cody B Doerflein, Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 214 W Freeman St, Carbondale, IL 62901 Phone: 812-491-1307 Fax: 618-549-0226 | |
Kristy Travis, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1237 E Main St, Carbondale, IL 62901 Phone: 618-549-0721 | |
Marcel De Wit, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 900 E Walnut St Ste 1, Carbondale, IL 62901 Phone: 618-319-7540 | |
Mrs. Lorraine M Scimeca, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 305 W Jackson St, Suite Ll02, Carbondale, IL 62901 Phone: 618-549-0721 Fax: 618-529-0403 | |
Ms. Michelle Alonzo Discaya, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 405 West Jackson St., Memorial Hospital Of Carbondale, Carbondale, IL 62901 Phone: 618-529-0516 Fax: 618-529-0403 | |
Athletico Physical Therapy Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 900 E Walnut St, Ste 1, Carbondale, IL 62901 Phone: 618-319-7540 Fax: 618-319-7542 |