Provider Demographics
NPI:1942173794
Name:VAN LERBERG, ISABEL
Entity type:Individual
Prefix:
First Name:ISABEL
Middle Name:
Last Name:VAN LERBERG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16400 W 63RD ST
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66217-9704
Mailing Address - Country:US
Mailing Address - Phone:913-206-5020
Mailing Address - Fax:
Practice Address - Street 1:11827 W 112TH ST STE 100
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-2700
Practice Address - Country:US
Practice Address - Phone:913-296-7636
Practice Address - Fax:913-296-7638
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-27
Last Update Date:2025-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR0739225100000X
KS11-01373225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty