Kapuno, Omega Amy T

Kapuno, Omega Amy T is an individual health care provider with primary practice located at 1504 East Grove , Rantoul IL 61866-2736. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Kapuno, Omega Amy T can be contacted via phone (217) 893-7720.

Contact Information

Primary practice address
1504 East Grove Rantoul IL 61866-2736
Phone: (217) 893-7720
Fax: (217) 893-7803
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 070009185 Illinois

Profile Details

NPI number 1720105612
LBN Legal business name Kapuno, Omega Amy T
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 23rd, 2007
Last updated Sep 20th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720105612 NPPES
Illinois Other 203 BLUE CROSS PROV ID
Illinois Other 4117 BLUE CROSS PROV ID
Illinois Other 7216 BLUE CROSS PROV ID
Illinois Other 113326 BLUE CROSS PROV ID

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