Provider Demographics
NPI:1760887731
Name:ABBEY, REBECCA M (LMT)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:M
Last Name:ABBEY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:NORTH PEKIN
Mailing Address - State:IL
Mailing Address - Zip Code:61554-1010
Mailing Address - Country:US
Mailing Address - Phone:309-202-2409
Mailing Address - Fax:
Practice Address - Street 1:2511 N MAIN ST
Practice Address - Street 2:
Practice Address - City:EAST PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61611-1783
Practice Address - Country:US
Practice Address - Phone:309-204-6571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-03
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL227016172225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist