Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jacob Frericks, PTA

Individual provider Physical Therapy Assistant · NPI 1558623835

Jacob Frericks, PTA is a Physical Therapy Assistant in Macomb, Illinois. Licensed in Illinois. Registered with an NPI since 2012.

Licensed in
IL
In the registry since
2012
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

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Practice location Address checks out

130 S Lafayette St Ste A
Macomb, IL 61455-2289
Phone: (309) 836-2500
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 160005557 (IL)

Record details

NPI number1558623835
Entity typeIndividual (Type 1)
GenderMale
Credentials PTA
Sole proprietorNo
NPI enumeratedJune 12, 2012
Last updated in NPPESJune 12, 2012
Mailing address135 N Williamsburg Dr, Bloomington, IL 61704-3528

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