1679746150 NPI number — FRANCES YANKEE PHYSICAL THERPIST

Table of content: FRANCES YANKEE PHYSICAL THERPIST (NPI 1679746150)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679746150 NPI number — FRANCES YANKEE PHYSICAL THERPIST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
YANKEE
Provider First Name:
FRANCES
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PHYSICAL THERPIST
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1679746150
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/07/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6695 SAFFORD RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROCKFORD
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
61101-2257
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
815-742-2475
Provider Business Mailing Address Fax Number:
815-961-1434

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6695 SAFFORD RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROCKFORD
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
61101-2257
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
815-742-2475
Provider Business Practice Location Address Fax Number:
815-961-1434
Provider Enumeration Date:
04/07/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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