Bret Tibay Pelesco, PT, DPT
Physical Therapist in Marshall, IL. Individual provider (NPI-1).
NPI number1780468009
StatusActive
Last updated in NPPESAug 21, 2023
Details
- NPI
- 1780468009
- Entity type
- Individual (NPI-1)
- Name
- Bret Tibay Pelesco
- Credential
- PT, DPT
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Aug 21, 2023
- Certification date
- Aug 20, 2023
- Last updated
- Aug 21, 2023
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 | 070027209 | IL | Yes |
Practice location
410 N 2nd StMarshall, IL 62441-1010
Phone 217-826-2358
Mailing address
102 Brosman Ln Apt 2Marshall, IL 62441-1096
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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 8 Physical Therapist providers in Marshall · All 77 providers in Marshall
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