Provider Demographics
NPI:1609535913
Name:MCLAUGHLIN, EMILY MARIE (PTA)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:MARIE
Last Name:MCLAUGHLIN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 S EADS AVE
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:IL
Mailing Address - Zip Code:61944-1938
Mailing Address - Country:US
Mailing Address - Phone:217-465-5395
Mailing Address - Fax:
Practice Address - Street 1:310 S EADS AVE
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:IL
Practice Address - Zip Code:61944-1938
Practice Address - Country:US
Practice Address - Phone:217-465-5395
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-14
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL160.008798225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant