Provider Demographics
NPI:1992037279
Name:POSPISCHIL, EMILY E (DPT)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:E
Last Name:POSPISCHIL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:E
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:850 43RD AVE
Mailing Address - Street 2:STE 100
Mailing Address - City:MOLINE
Mailing Address - State:IL
Mailing Address - Zip Code:61265-8401
Mailing Address - Country:US
Mailing Address - Phone:309-743-2070
Mailing Address - Fax:309-743-2073
Practice Address - Street 1:1008 W 35TH ST
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52806-5827
Practice Address - Country:US
Practice Address - Phone:563-324-2263
Practice Address - Fax:563-324-7019
Is Sole Proprietor?:No
Enumeration Date:2010-02-11
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070017627225100000X
IA004590225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
070017627OtherILLINOIS P T LICENSE NUMBER
IA004590OtherIOWA PT LICENSE
IL555640013Medicare Oscar/Certification
IAI18344030Medicare Oscar/Certification