Doctor Name: | JASON REDEKER |
NPI Number: | 1386897692 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.P.T. |
License Number: | 070016475 |
Business Practice Address: | 810 W Anthony Dr Urbana, IL - 618027431 |
Business Phone Number: | 2173262911 |
Business Fax Number: | 2173448047 |
Mailing Address: | 611 W Park St, URBANA |
State: | IL |
Postal Code: | 618012500 |
Phone Number: | 2173262911 |
Fax Number: | 2173448047 |
NPI Enumeration Date: | 10/30/2008 |
NPI Last Update Date: | 04/27/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 070016475 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |