| Real Rehabilitation Pc | |
|
811 N 1st St, Vienna, IL 62995-1544 | |
| (618) 658-8144 | |
| (618) 658-9146 |
| Full Name | Real Rehabilitation Pc |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 811 N 1st St, Vienna, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912030321 | NPI | - | NPPES |
| 048930 | Other | IL | HEALTH ALLIANCE INSURANCE |
| 1179027 | Other | IL | FIRST HEALTH INSURANCE |
| 4423522 | Other | IL | BCBS |
| 59671 | Other | IL | GHP INSURANCE |
| 327609256001 | Medicaid | IL | |
| 431187 | Other | IL | HEALTHLINK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | (* (Not Available)) | Primary |
| Provider Name | Rachel A Edmonds |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1235147216 PECOS PAC ID: 5092790014 Enrollment ID: I20110128000812 |
| Provider Name | Cody W Hubble |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1588120463 PECOS PAC ID: 6800218728 Enrollment ID: I20200623002585 |
| Mailing Address | Practice Location Address |
|---|---|
| Real Rehabilitation Pc Po Box 95, Vienna, IL 62995-0095 Ph: (618) 658-8144 | Real Rehabilitation Pc 811 N 1st St, Vienna, IL 62995-1544 Ph: (618) 658-8144 |
Kimberly Dawn Ecker, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 811 N 1st Street, Vienna, IL 62995 Phone: 618-658-8144 Fax: 618-658-9146 | |
Michael Brantley Stricker, PT, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 811 N 1st St, Vienna, IL 62995 Phone: 618-658-8144 Fax: 618-658-9146 | |
Rachel Ann Edmonds, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 811 N 1st Street, Vienna, IL 62995 Phone: 618-658-8144 Fax: 618-658-9146 | |
Mr. Gregory M Blakely, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 811 North 1st Street, Vienna, IL 62995 Phone: 618-658-8144 Fax: 618-658-9146 | |
Jessica Renee Mccowan, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 811 N 1st St, Vienna, IL 62995 Phone: 618-658-8144 Fax: 618-658-9146 |