IndividualActive
Adam Moody, PTA
NPI 1194237677 · Physical Therapy Clinic/Center · Kankakee, IL
Provider details
- NPI number
- 1194237677
- Entity type
- Individual
- Primary specialty
- Physical Therapy Clinic/CenterAmbulatory Health Care Facilities
- Credential
- PTA
- Sex
- Male
- Sole proprietor
- Yes
- License
- 160006509 (IL)
Mailing address
7 Durell Dr
Kankakee, IL 60901-6001
Registry dates
- Enumerated
- 2017-10-24
- Last updated
- 2017-10-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.