Provider Demographics
NPI:1407110117
Name:GETZ, EMILY K (PT)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:K
Last Name:GETZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2338 VAN WINKLE WAY
Mailing Address - Street 2:SUITE 3100
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61615-7482
Mailing Address - Country:US
Mailing Address - Phone:309-693-9189
Mailing Address - Fax:309-693-9946
Practice Address - Street 1:2338 VAN WINKLE WAY
Practice Address - Street 2:SUITE 3100
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61615-7482
Practice Address - Country:US
Practice Address - Phone:309-693-9189
Practice Address - Fax:309-963-9946
Is Sole Proprietor?:No
Enumeration Date:2012-06-27
Last Update Date:2013-01-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL070019178225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILP01102975OtherRR MEDICARE
ILP01102975OtherRR MEDICARE