MS. REBECCA ANNE WILDERMUTH (NPI# 1013050046) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013050046 |
| Entity Type | Individual |
| Full Name | MS. REBECCA ANNE WILDERMUTH |
| Credential | MS ATC CSCS |
| Practice Address |
10 Doctors Park Gibson City IL 60936 |
| Mailing Address |
301 E Willow St Normal IL 61761 |
| Practice Telephone | 2177842650 |
| Practice Fax Number | 2177848023 |
| Mailing Telephone | 3098621786 |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
IL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
10 DOCTORS PARK |
| City | GIBSON CITY |
| State | IL |
| Zip Code | 60936 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154328805 | Lalchand T Goyal | Internal Medicine | 10 Doctors Park, Gibson City, IL 60936-2009 | 2005-07-07 |
| 1801439161 | Kacy Marie Murphy | Orthopaedic Surgery | 10 Doctors Park, Gibson City, IL 60936-2004 | 2019-10-18 |
| 1801313077 | Erin J. Miller | Physician Assistant | 10 Doctors Park, Gibson City, IL 60936-2004 | 2017-08-28 |
| 1821440405 | Sarah Hong-conder | Nurse Practitioner | 10 Doctors Park, Gibson City, IL 60936-2004 | 2016-07-07 |
| 1558724310 | Carrie Kirby | Nurse Practitioner | 10 Doctors Park, Gibson City, IL 60936-2004 | 2016-03-30 |
| 1134540750 | Gibson Community Hospital Association | Internal Medicine | 10 Doctors Park, Gibson City, IL 60936-2009 | 2013-12-27 |
| 1285982249 | Gibson Area Hospital | General Acute Care Hospital | 10 Doctors Park, Gibson City, IL 60936-2009 | 2012-08-23 |
| 1154679108 | Gibson Area Hospital Therapy Services | General Acute Care Hospital | 10 Doctors Park, Gibson City, IL 60936-2009 | 2012-08-23 |
| 1790097582 | Jason Ye | Orthopaedic Surgery | 10 Doctors Park, Gibson City, IL 60936-2004 | 2010-07-08 |
| 1578799797 | Gibson Community Hospital Association | Specialist | 10 Doctors Park, Gibson City, IL 60936-2009 | 2009-06-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073738738 | Carrie Ann Lithgow | Physical Therapist | 109 N. Sangamon Ave, Gibson City, IL 60936 | 2007-04-16 |
| 1144359001 | Kerrie Ann Patrick | Registered Nurse | 222 N Sangamon, Gibson City, IL 60936 | 2007-03-05 |
| 1578612800 | Donna J Boundy | Dentist | 627 E 8th St, Gibson City, IL 60936 | 2007-01-09 |
| 1093878241 | Drew Curtis Duquette | Chiropractor | 523 and One Half South Sangamon Ave, Gibson City, IL 60936 | 2006-12-19 |
| 1386727642 | Amnuay Sethakorn | Family Medicine | 4 Doctors Park, Gibson City, IL 60936 | 2006-10-23 |
| 1689687295 | Alexander V Grandt | Nurse Practitioner | 1120 N Melvin, Gibson Area Hospital & Health Services, Gibson, IL 60936 | 2006-08-14 |
| 1811125784 | Gibson Community Hospital Association | Surgery | 1 Doctors Park, Gibson City, IL 60936 | 2009-06-30 |
| 1295991701 | Trilok Shah | Psychiatry & Neurology | 4 Doctors Park, Gibson City, IL 60936 | 2008-08-04 |
| 1245312602 | Ginny E Pulley | Licensed Practical Nurse | 222 N Sangamon Ave, Gibson City, IL 60936 | 2006-10-19 |
| 1518065358 | Karen Marie Leenerman | Registered Nurse | 222 N Sangamon Ave, Gibson City Clinic Sc, Gibson City, IL 60936 | 2006-09-20 |
| Find all providers in zip 60936 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104008333 | Tyler Brucker | Specialist/Technologist | 10 Doctors Park, Gibson City, IL 60936-2009 | 2007-11-29 |
| 1699805481 | Marco S Boscolo | Specialist/Technologist | 10 Doctors Park, Gibson City, IL 60936-2009 | 2007-03-07 |
| 1740262344 | Kenneth E Meisner | Specialist/Technologist | 10 Doctors Park, Gibson City, IL 60936-2000 | 2005-11-18 |
| 1780675660 | Chad Eric Vaughn | Specialist/Technologist | 10 Doctors Park, Gibson City, IL 60936-2000 | 2005-10-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538771076 | Stacey Weathers-cannon | Specialist/Technologist | 650 Ingraham Ave, Calumet City, IL 60409-4236 | 2020-08-17 |
| 1104438621 | Abril Malagon | Specialist/Technologist | 1 S Greenwood Ave, Palatine, IL 60074-6328 | 2020-08-17 |
| 1265050678 | Megan Elsbree | Specialist/Technologist | 11819 Deacon Dr, Rockton, IL 61072-9411 | 2020-07-13 |
| 1013534437 | Nicole Rose Mondelli | Specialist/Technologist | 958 Tallgrass Dr, Bartlett, IL 60103-5071 | 2020-07-01 |
| 1740806413 | Megan Herter | Specialist/Technologist | 1513 Old Ivy Dr, Springfield, IL 62711-8156 | 2020-06-18 |
| 1164047239 | Madison Stagman | Specialist/Technologist | 280 Douglas Ave Apt 4, Mascoutah, IL 62258-2963 | 2020-06-14 |
| 1588286272 | Sarah Wegrzyn | Specialist/Technologist | 3040 S Wabash Ave, Chicago, IL 60616-3474 | 2020-05-15 |
| 1336761386 | Christine Louise Shebelski | Specialist/Technologist | 15203 Pulaski Rd, Midlothian, IL 60445-3755 | 2020-05-13 |
| 1386266633 | Kathryn Riordan | Specialist/Technologist | 221 Triton Ln, Naperville, IL 60540-7926 | 2020-05-09 |
| 1487276747 | Vianey Hernandez-ramirez | Specialist/Technologist | 4115 Howard St, Skokie, IL 60076-3749 | 2020-05-09 |
| Find all providers with the same taxonomy | ||||
| City | GIBSON CITY |
| Zip Code | 60936 |
Please comment or provide details below to improve the information on MS. REBECCA ANNE WILDERMUTH.
| 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.