Provider Demographics
NPI:1992922918
Name:CYMRU THERAPY INC
Entity type:Organization
Organization Name:CYMRU THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANINE
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:BOEHME
Authorized Official - Suffix:
Authorized Official - Credentials:LPT
Authorized Official - Phone:217-825-9448
Mailing Address - Street 1:2834 FORREST LANE
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:IL
Mailing Address - Zip Code:62521
Mailing Address - Country:US
Mailing Address - Phone:217-825-9448
Mailing Address - Fax:217-422-5449
Practice Address - Street 1:2834 FORREST LANE
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:IL
Practice Address - Zip Code:62521
Practice Address - Country:US
Practice Address - Phone:217-825-9448
Practice Address - Fax:217-422-5449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL05832027OtherBCBS PROVIDER NUMBER