Provider Demographics
NPI:1770709115
Name:MCGEHEE, WILLIAM FRANKLIN JR (PT)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:FRANKLIN
Last Name:MCGEHEE
Suffix:JR
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 1:306 CIRCUIT CT
Mailing Address - Street 2:
Mailing Address - City:EAST PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61611-1433
Mailing Address - Country:US
Mailing Address - Phone:309-694-1509
Mailing Address - Fax:
Practice Address - Street 1:112 NE MADISON AVE
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61602-1109
Practice Address - Country:US
Practice Address - Phone:309-674-7874
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070009207225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist