Physicians Sports and Injury Center

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038.013069 Issued in IL

Legal business name

PHYSICIANS SPORTS AND INJURY CENTER

Practice address

777 Oakmont LN Ste 1000
Westmont, IL 60559-5503

Phone

(630) 323-2225

NPI assigned

Feb 27, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Heather Peterson

Title

Office Managert

Phone

(630) 323-2225

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1488153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488153600000",
    "number": "1043750938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 OAKMONT LN STE 1000",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605595503",
            "telephone_number": "630-323-2225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 OAKMONT LN STE 1000",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605595503",
            "telephone_number": "630-323-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS SPORTS AND INJURY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-27",
        "last_updated": "2017-02-27",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "OFFICE MANAGERT",
        "authorized_official_telephone_number": "630-323-2225"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.013069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shavon Petties, CST, CSFA
• Physical Sciences Institute, Inc.
• Physical Sciences Institute, Inc.
• Physicians Edge Pho
• Physicians Sports & Injury Center, Inc
• Jessica Elizabeth Piry
• Erin Podgorny, MS APN AGNP-C
• Anne Pohlman
• Preeti Poindexter
• Mari Jo Pollmann

• Chiropractor in Westmont, IL
• Providers in Westmont, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.