Active NPI
Stacey Penaflor
- Physical Therapist
- Dixon, IL
National Provider Identifier
1033919659
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070.026999
- Practice address
- 403 E 1St St
Dixon, IL 61021-3116 - Phone
- (815) 285-5591
- NPI assigned
- Mar 13, 2025
- Sex
- Unspecified or another gender identity
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070.026999 | IL | Primary |
Addresses
Primary practice location
403 E 1St St
Dixon, IL 61021-3116
Mailing address
1307 W 2ND St
Rock Falls, IL 61071-1004
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070.026999 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1741824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1741824000000",
"number": "1033919659",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1307 W 2ND ST",
"city": "ROCK FALLS",
"state": "IL",
"postal_code": "610711004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "403 E 1ST ST",
"city": "DIXON",
"state": "IL",
"postal_code": "610213116",
"telephone_number": "815-285-5591"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENAFLOR",
"first_name": "STACEY",
"sole_proprietor": "NO",
"sex": "X",
"enumeration_date": "2025-03-13",
"last_updated": "2025-03-13",
"certification_date": "2025-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070.026999",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dixon, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.