SAMANTHA PERCICH (NPI# 1639623911) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639623911 |
| Entity Type | Individual |
| Full Name | SAMANTHA PERCICH |
| Other Name | SAMANTHA SCHLAKE |
| Practice Address |
4280 S State Route 159 Glen Carbon IL 62034-3269 |
| Mailing Address |
15 Apex Dr Highland IL 62249-1282 |
| Practice Telephone | 6182884233 |
| Mailing Telephone | 6184410482 |
| Enumeration Date | 2016-08-04 |
| Last Update Date | 2018-10-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251X0800X |
Physical Therapist Specialization: Orthopedic |
2016027389 | MO | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
4280 S STATE ROUTE 159 |
| City | GLEN CARBON |
| State | IL |
| Zip Code | 62034-3269 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942464045 | Apex Physical Therapy, LLC | Clinic/Center | 4280 S State Route 159, Ste 3, Glen Carbon, IL 62034-3269 | 2008-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740787795 | Kaleena Galletta | Nurse Practitioner | 4273 S., Il - 159, Glen Carbon, IL 62034 | 2018-04-06 |
| 1871092502 | Andrea Lee Sullivan | Dentist | 3024 South Il-159, Glen Carbon, IL 62034 | 2018-02-08 |
| 1417464918 | Stages Health & Wellness, LLC | Nurse Practitioner | 14 Crabapple Lane, Glen Carbon, IL 62034 | 2018-01-05 |
| 1700300498 | Michael Jay Arnold | Dentist | 3024 Il-159, Glen Carbon, IL 62034 | 2017-08-03 |
| 1679024228 | 360 Body Wellness Inc | Internal Medicine | 3407 Il State Route 157, Glen Carbon, IL 62034 | 2016-10-19 |
| 1346621505 | Stephanie N Lorts | Pediatrics | 4804 South State Route 159, Glen Carbon, IL 62034 | 2015-06-13 |
| 1205110111 | James Allan Staley | Pharmacist | #2 Cottonwood Rd, Glen Carbon, IL 62034 | 2011-10-11 |
| 1215224357 | Angela Eleni Kioultzopoulos | Speech-Language Pathologist | 7a Ginger Creek Village Dr., Glen Carbon, IL 62034 | 2011-07-08 |
| 1922320795 | Meridian Village Association | Skilled Nursing Facility | 27 Auerbach Place, Glen Carbon, IL 62034 | 2010-02-22 |
| 1679728356 | Erin Kathleen Immken | Counselor | 98 Junction Drive West, Suite 6, Glen Carbon, IL 62034 | 2008-11-24 |
| Find all providers in zip 62034 | ||||
| Taxonomy Code | 2251X0800X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Orthopedic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629521802 | Laura Szczepan | Physical Therapist | 4955 S State Route 159, Ste. B, Glen Carbon, IL 62034-1907 | 2016-07-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659986891 | Murtaza Aziz | Physical Therapist | 1431 N Western Ave Ste 140, Chicago, IL 60622-1770 | 2020-09-14 |
| 1902416720 | Epicore Physical Therapy | Physical Therapist | 1660 N La Salle Dr Apt 2708, Chicago, IL 60614-6021 | 2020-08-06 |
| 1356968374 | Genevieve Joy Owen | Physical Therapist | 555 Busse Hwy Unit C1, Park Ridge, IL 60068-3189 | 2020-06-26 |
| 1518597772 | Stability Physical Therapy and Wellness, LLC | Physical Therapist | 5031 W Balmoral Ave, Chicago, IL 60630-1507 | 2020-01-16 |
| 1154972719 | Antonio Marquez | Physical Therapist | 7425 Janes Ave Ste 200, Woodridge, IL 60517-2358 | 2019-09-25 |
| 1376198978 | Natalie N Ruebke | Physical Therapist | 251 Marketplace Dr # 2, Freeburg, IL 62243-4082 | 2019-08-09 |
| 1902360241 | Stephanie Lynne Burkhart | Physical Therapist | 12251 W 159th St, Homer Glen, IL 60491-7847 | 2019-01-30 |
| 1003388943 | Scoliosis Therapy Care and More LLC | Physical Therapist | 4n369 Booth Tarkington St, St Charles, IL 60175-7731 | 2018-12-17 |
| 1912478082 | Brandon Donnelly | Physical Therapist | 2200 Fort Jesse Rd Ste 230, Normal, IL 61761-6291 | 2018-12-16 |
| 1497251086 | John William Herbert | Physical Therapist | 1316 N Route 59, Naperville, IL 60563-4286 | 2018-04-03 |
| Find all providers with the same taxonomy | ||||
| City | GLEN CARBON |
| Zip Code | 62034 |
Please comment or provide details below to improve the information on SAMANTHA PERCICH.
| 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.