Individual provider Active NPI

Melissa C Peterson, DPT

  • Physical Therapist
  • Naperville, IL
National Provider Identifier
1073046652
Registry record updated Dec 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070023205 Issued in IL
Practice address
4003 S Route 59
Naperville, IL 60564-5802
Phone
(630) 967-2000
Fax
(815) 730-6368
NPI assigned
Apr 10, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070023205 IL Primary

Addresses

Primary practice location

4003 S Route 59
Naperville, IL 60564-5802

Mailing address

Pob 7132960
Chicago, IL 60677-0001
Phone (630) 469-9200

Other practice location 1

777 N York Rd
Hinsdale, IL 60521-3559
Phone (630) 819-8384

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mpeterson293805@dulyhealthandcare.direct-ci.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170914002155 IL Practitioner - Physical Therapist in Private Practice 5092089029 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dupage Medical Group LTDGroup PAC ID 5496667941, 1,326 clinicians

Practice addresses (Care Compare)

1325 N Meacham Rd
Schaumburg, IL 60173-4824
Phone (630) 469-9200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Impact Physical Therapy, LLC Physical Therapist CurrentSince Sep 1, 2024 Accepting new patients
Ipt Management Services, Inc. Physical Therapist CurrentSince Dec 20, 2021 Accepting new patients
Dupage Medical Group LTD CurrentSince Sep 9, 2025 Accepting new patients
Dupage Medical Group LTD Physical Therapist CurrentSince Sep 9, 2025 Accepting new patients

Locations

1103 S State St
Ste 300
Chicago, IL 60605
Phone (312) 877-5101

777 N York Rd
Ste 11
Hinsdale, IL 60521
Phone (630) 819-8384

4003 S Route 59
Naperville, IL 60564

116 W Gartner Rd
Ste 104
Naperville, IL 60540
Phone (331) 229-3632

1325 N Meacham Rd
Schaumburg, IL 60173
Phone (630) 790-1700

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

Interoperability endpoints

  • Direct secure messaging: mpeterson293805@dulyhealthandcare.direct-ci.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1491782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735257600000",
    "number": "1073046652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "POB 7132960",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606770001",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4003 S ROUTE 59",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605645802",
            "telephone_number": "630-967-2000",
            "fax_number": "815-730-6368"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "777 N York Rd",
            "address_purpose": "LOCATION",
            "city": "Hinsdale",
            "state": "IL",
            "postal_code": "605213559",
            "country_code": "US",
            "telephone_number": "630-819-8384",
            "fax_number": "630-468-0605",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "MELISSA",
        "middle_name": "C",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-10",
        "last_updated": "2024-12-27",
        "certification_date": "2024-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070023205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mpeterson293805@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4003 S Route 59",
            "city": "Naperville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605645802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.