Basic Information
| Provider Information | |||||||||
| NPI: | 1003017849 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RICHELMAN | ||||||||
| FirstName: | HEATHER | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2760 CALVARY CEMETERY RD | ||||||||
| Address2: | |||||||||
| City: | CAMPBELL HILL | ||||||||
| State: | IL | ||||||||
| PostalCode: | 629162213 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6184263480 | ||||||||
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| Practice Location | |||||||||
| Address1: | 900 N. WASHINGTON | ||||||||
| Address2: | |||||||||
| City: | DUQUOIN | ||||||||
| State: | IL | ||||||||
| PostalCode: | 62832 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6185422146 | ||||||||
| FaxNumber: | 6185424756 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/30/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | IL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.