Individual ProviderDerek KeltonPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address2325 W Monroe St, Springfield, IL 62704-1452(217) 547-2497PECOS EnrollmentBased on the most recent information from CMS, provider Derek Kelton 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 ID1386138444Provider TypeIndividualFull NameKelton, DerekGenderMaleSole ProprietorNoEnumeration Date6/21/2018Last Updated11/7/2024Contact InformationPractice LocationPractice Address2325 W Monroe St, Springfield, IL 62704-1452Phone(217) 547-2497FaxUnlisted FaxMailing LocationMailing AddressPO Box 19248, Springfield, IL 62794-9248PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense070028643IllinoisCode225100000XDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseUnlisted Issuer