Vidit Atul Phanse, | |
620 W Bridgeport St, White Hall, IL 62092-1001 | |
(217) 374-6714 | |
Not Available |
Full Name | Vidit Atul Phanse |
---|---|
Gender | Male |
Speciality | Physical Therapy |
Experience | 8 Years |
Location | 620 W Bridgeport St, White Hall, Illinois |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1043731540 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 070.022922 (Illinois) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Athletic And Therapeutic Institute Of Bourbonnais, Llc | 4183692577 | 143 |
Athletic And Therapeutic Institute Of Naperville, Llc | 8325014020 | 209 |
Provider Name | Athletic And Therapeutic Institute Of Naperville, Llc |
---|---|
Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1023129681 PECOS PAC ID: 8325014020 Enrollment ID: O20040903000494 |
Provider Name | Athletic And Therapeutic Institute Of Bourbonnais, Llc |
---|---|
Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1861503542 PECOS PAC ID: 4183692577 Enrollment ID: O20040923000220 |
Mailing Address | Practice Location Address |
---|---|
Vidit Atul Phanse, 790 Remington Blvd, Bolingbrook, IL 60440-4909 Ph: () - | Vidit Atul Phanse, 620 W Bridgeport St, White Hall, IL 62092-1001 Ph: (217) 374-6714 |
Loida Lim Baculanta, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 549 N Main St, Apt 4, White Hall, IL 62092 Phone: 217-416-8032 | |
Netherine Lann Valencia Agsalda, RPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 620 W Bridgeport St., White Hall Nursing And Rehab, White Hall, IL 62092 Phone: 217-374-2144 |