Provider Demographics
NPI:1174025506
Name:BAALMAN, ABBY LEIGH (DPT)
Entity Type:Individual
Prefix:MISS
First Name:ABBY
Middle Name:LEIGH
Last Name:BAALMAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ABBY
Other - Middle Name:LEIGH
Other - Last Name:SCHLEEPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:1719 CLAWSON STREET
Mailing Address - Street 2:
Mailing Address - City:ALTON
Mailing Address - State:IL
Mailing Address - Zip Code:62002
Mailing Address - Country:US
Mailing Address - Phone:618-462-1133
Mailing Address - Fax:618-462-3736
Practice Address - Street 1:314 5TH ST
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:IL
Practice Address - Zip Code:62016-1325
Practice Address - Country:US
Practice Address - Phone:217-409-6405
Practice Address - Fax:217-305-7282
Is Sole Proprietor?:No
Enumeration Date:2018-03-01
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070-023521225100000X
IL070.023521225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL070.023521OtherPROFESSIONAL LICENSE