Provider Demographics
NPI:1811963713
Name:BLOCKI, SONDRA L (MSPT)
Entity type:Individual
Prefix:MS
First Name:SONDRA
Middle Name:L
Last Name:BLOCKI
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2200 MARQUETTE ROAD
Mailing Address - Street 2:STE 111
Mailing Address - City:PERU
Mailing Address - State:IL
Mailing Address - Zip Code:61354-1569
Mailing Address - Country:US
Mailing Address - Phone:815-220-8787
Mailing Address - Fax:815-220-8790
Practice Address - Street 1:2200 MARQUETTE ROAD
Practice Address - Street 2:STE 111
Practice Address - City:PERU
Practice Address - State:IL
Practice Address - Zip Code:61354-1569
Practice Address - Country:US
Practice Address - Phone:815-220-8787
Practice Address - Fax:815-220-8790
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2007-07-19
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
05032044OtherBCBS
201836513000OtherCIGNA
201836513000OtherCIGNA