Prorehab PC
Physical Therapist in Lake St Louis, MO. Organization (NPI-2).
NPI number1043661465
StatusActive
Last updated in NPPESJun 28, 2016
Details
- NPI
- 1043661465
- Entity type
- Organization (NPI-2)
- Legal business name
- Prorehab PC
- Organization subpart
- No
- Enumeration date
- Jun 27, 2016
- Last updated
- Jun 28, 2016
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | – | – | Yes |
Other names
- Athletico Physical Therapy (Doing Business As)
Practice location
6309 Ronald Reagan DrLake St Louis, MO 63367-2681
Phone 636-755-4566 · Fax 636-561-0242
Mailing address
625 Enterprise DrOak Brook, IL 60523-8813
Phone 630-575-1980
Authorized official
Geri Cook
Director Of Clinical Services
6305751940
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 27 Physical Therapist providers in Lake St Louis · All 376 providers in Lake St Louis
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