PAM RADTKE (NPI# 1184783607) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184783607 |
| Entity Type | Individual |
| Full Name | PAM RADTKE |
| Credential | DT |
| Practice Address |
1306 Wabash Ave Belleville IL 62220-3370 |
| Practice Telephone | 6182346876 |
| Practice Fax Number | 6182346150 |
| Mailing Telephone | 6182346876 |
| Mailing Fax Number | 6182346150 |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 225400000X | Rehabilitation Practitioner | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| X | 225500000X | Specialist/Technologist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
1306 WABASH AVE |
| City | BELLEVILLE |
| State | IL |
| Zip Code | 62220-3370 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972553709 | Special Children, Inc. | Early Intervention Provider Agency | 1306 Wabash Ave, Belleville, IL 62220-3370 | 2006-05-11 |
| 1417268053 | Kimberly Lee Senters | Developmental Therapist | 1306 Wabash Ave, Belleville, IL 62220-3370 | 2010-06-29 |
| 1356669493 | Amy Lester | Developmental Therapist | 1306 Wabash Ave, Belleville, IL 62220-3370 | 2010-05-13 |
| 1558509984 | Teresa M. Applegate | Speech-Language Pathologist | 1306 Wabash Ave, Belleville, IL 62220-3370 | 2009-01-22 |
| 1740452010 | Ingrid Zarins | Developmental Therapist | 1306 Wabash Ave, Belleville, IL 62220-3370 | 2008-03-27 |
| 1629137138 | Sarah Elizabeth Day | Speech-Language Pathologist | 1306 Wabash Ave, Belleville, IL 62220-3370 | 2006-12-08 |
| 1033211412 | Julie Malherek | Physical Therapist | 1306 Wabash Ave, Belleville, IL 62220-3370 | 2006-09-05 |
| 1366544983 | Jean Morgan | Developmental Therapist | 1306 Wabash Ave, Belleville, IL 62220-3370 | 2006-09-03 |
| 1477655041 | Karen Miller | Speech-Language Pathologist | 1306 Wabash Ave, Belleville, IL 62220-3370 | 2006-09-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144729716 | St. Elizabeth's Hospital of The Hospital Sisters of The Third Order Of | Clinic/Center | 180 South Third Street Suite 101, Belleville, IL 62220 | 2018-02-08 |
| 1437675535 | Prorehab PC | Occupational Therapist | 1915 Carlyle Ave, Ste D, Belleville, IL 62220 | 2017-08-21 |
| 1629527650 | Arika Forrest | Nurse Practitioner | 140 Iowa Ave, Belleville, IL 62220 | 2016-10-03 |
| 1861861403 | Belleville Endoscopy LLC | Internal Medicine | 311 West Lincoln St, Suite 101, Belleville, IL 62220 | 2015-09-24 |
| 1962871558 | Antony Frierdich | Specialist/Technologist | 22 South 13th Street, Belleville, IL 62220 | 2015-09-24 |
| 1588032858 | Dana Wright | Pharmacist | 211 South Thrid Street, Belleville, IL 62220 | 2015-09-03 |
| 1629208731 | Lisa Marlow Johnson | Developmental Therapist | 34 Fenwood Dr, Belleville, IL 62220 | 2009-07-23 |
| 1841361623 | Neurological Surgery of Belleville | Neurological Surgery | 340 West Lincoln Street, Suite 540, Belleville, IL 62220 | 2006-11-13 |
| 1689769119 | Kathy Jo Corn | Counselor | 521 W. Main, Suite 201 B, Belleville, IL 62220 | 2006-10-03 |
| 1780609578 | Southern Illinois Health Care Foundation, Inc. | Counselor | 180 S 3rd St Ste 103&104, Belleville, IL 62220 | 2006-07-13 |
| Find all providers in zip 62220 | ||||
| Taxonomy Code | 225400000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Rehabilitation Practitioner |
| A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487276481 | Nicole Lewis | Rehabilitation Practitioner | 15300 W Hoff Rd, Manhattan, IL 60442-9326 | 2020-05-12 |
| 1992330799 | Complete Rehab and Consultation Inc | Rehabilitation Practitioner | 120 Sonoma Rd, New Lenox, IL 60451-3291 | 2020-03-12 |
| 1689189706 | Joseph Jorgenson | Rehabilitation Practitioner | Hines Brc Bld 113, 5000 S 5th Ave, 124, Hines, IL 60141 | 2017-12-12 |
| 1770098220 | Corinne Nicole Nero | Rehabilitation Practitioner | 5000 S 5th Ave Bldg 113, Hines, IL 60141-3030 | 2017-12-06 |
| 1154711570 | Jonathan Robert Gilliand | Rehabilitation Practitioner | 330 Ponderosa Dr, Bradley, IL 60915-1143 | 2015-01-24 |
| 1396133609 | Benedict Chang | Rehabilitation Practitioner | 5610 N Mango Ave, Chicago, IL 60646-6306 | 2015-01-08 |
| 1417350414 | Billy Tatum | Rehabilitation Practitioner | 1436 W. Randolph, 5th Floor, Chicago, IL 60607 | 2014-10-03 |
| 1093006546 | Nicole Berlowski | Rehabilitation Practitioner | 1501 Dogwood Dr, Woodridge, IL 60517-4649 | 2011-05-02 |
| 1417261538 | Gina Graff | Rehabilitation Practitioner | 1000 N Lasalle St, Apt 518, Chicago, IL 60610-2676 | 2010-07-30 |
| 1801022041 | Children's Therapy and Rehab Specialists | Rehabilitation Practitioner | 2531 Technology Dr Ste 313, Elgin, IL 60124-7889 | 2009-06-02 |
| Find all providers with the same taxonomy | ||||
| City | BELLEVILLE |
| Zip Code | 62220 |
Please comment or provide details below to improve the information on PAM RADTKE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.