NPI 1790220283 · live from the CMS NPI Registry
Elizabeth Omotayo Abe
Physical Therapist in Peoria, IL. National Provider Identifier 1790220283, active.
NPI record
| NPI | 1790220283 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physical Therapist 225100000X |
| Practice location | 3714 N Prospect Rd, Peoria, IL 61614 |
| Practice phone | 309-550-7888 |
| Mailing address | 600 Oakmont Ln Ste 600c, Westmont, IL 60559 |
| Enumerated | December 20, 2016 |
| Last updated | February 6, 2020 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physical Medicine & Rehabilitation | 208100000X | 070022228 (IL) |
| Physical Therapist primary | 225100000X | 070-022228 (IL) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.