Provider Demographics
NPI:1629045901
Name:BIEHL, TIMOTHY J (PT)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:J
Last Name:BIEHL
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4964 BENCHMARK CENTRE DR
Mailing Address - Street 2:
Mailing Address - City:SWANSEA
Mailing Address - State:IL
Mailing Address - Zip Code:62226-2028
Mailing Address - Country:US
Mailing Address - Phone:618-593-6469
Mailing Address - Fax:618-632-5855
Practice Address - Street 1:4964 BENCHMARK CENTRE DR
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:IL
Practice Address - Zip Code:62226-2028
Practice Address - Country:US
Practice Address - Phone:618-593-6469
Practice Address - Fax:618-632-5855
Is Sole Proprietor?:No
Enumeration Date:2006-03-04
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL38240374OtherBCBS IL
ILK21265Medicare PIN