Provider Demographics
NPI:1689926529
Name:RICE, SARAH (PT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:RICE
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 1:32699 N 3425 EAST RD
Mailing Address - Street 2:
Mailing Address - City:REDDICK
Mailing Address - State:IL
Mailing Address - Zip Code:60961-7022
Mailing Address - Country:US
Mailing Address - Phone:815-476-5210
Mailing Address - Fax:
Practice Address - Street 1:350 N WALL ST
Practice Address - Street 2:
Practice Address - City:KANKAKEE
Practice Address - State:IL
Practice Address - Zip Code:60901-2901
Practice Address - Country:US
Practice Address - Phone:815-476-5210
Practice Address - Fax:815-476-1080
Is Sole Proprietor?:No
Enumeration Date:2012-10-02
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070012546225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist