Individual ProviderMegan GibsonPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address2201 W White Oaks Dr, Springfield, IL 62704-6498(217) 546-3301PECOS EnrollmentBased on the most recent information from CMS, provider Megan Gibson does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1164087185Provider TypeIndividualFull NameGibson, MeganCredentialDPTGenderFemaleSole ProprietorNoEnumeration Date5/6/2019Last Updated12/5/2019Contact InformationPractice LocationPractice Address2201 W White Oaks Dr, Springfield, IL 62704-6498Phone(217) 546-3301FaxUnlisted FaxMailing LocationMailing Address269 Cypress Pt, Petersburg, IL 62675-9765PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseUnlisted IssuerCode225100000XDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense070024809Illinois