Pequette, Derek R

Pequette, Derek R is an individual health care provider with primary practice located at 1275 N Convent St Suite 3, Bourbonnais IL 60914-8210. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Pequette, Derek R can be contacted via phone (815) 936-1855.

Contact Information

Primary practice address
1275 N Convent St Suite 3 Bourbonnais IL 60914-8210
Phone: (815) 936-1855
Fax: (815) 936-6097
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 070012002 Illinois

Profile Details

NPI number 1568561074
LBN Legal business name Pequette, Derek R
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 21st, 2006
Last updated Mar 26th, 2015 - about 11 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 1568561074 NPPES
Illinois Other P00886041 MEDICARE RAILROAD
Illinois Other P00886041 MEDICARE RAILROAD

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