Provider Demographics
NPI:1437205325
Name:BAUMGART, SHERYL (PT)
Entity Type:Individual
Prefix:MS
First Name:SHERYL
Middle Name:
Last Name:BAUMGART
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 N US HIGHWAY 12
Mailing Address - Street 2:SUITE J
Mailing Address - City:SPRING GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60081-8322
Mailing Address - Country:US
Mailing Address - Phone:815-675-0699
Mailing Address - Fax:815-675-0689
Practice Address - Street 1:2900 N US HIGHWAY 12
Practice Address - Street 2:SUITE J
Practice Address - City:SPRING GROVE
Practice Address - State:IL
Practice Address - Zip Code:60081-8322
Practice Address - Country:US
Practice Address - Phone:815-675-0699
Practice Address - Fax:815-675-0689
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL70005775225100000X, 2251G0304X, 2251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Not Answered2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
Not Answered2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
Not Answered2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic