Provider Demographics
NPI:1306075577
Name:UEBERFLUSS, RICHARD EDWARD (PT)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:EDWARD
Last Name:UEBERFLUSS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 SULPHUR LANE
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:IL
Mailing Address - Zip Code:61944-6599
Mailing Address - Country:US
Mailing Address - Phone:217-822-7687
Mailing Address - Fax:
Practice Address - Street 1:24W500 MAPLE AVE
Practice Address - Street 2:SUITE 208
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-6055
Practice Address - Country:US
Practice Address - Phone:630-305-9100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-09
Last Update Date:2009-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0700065212251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic