Jeramie Lee Butts, PHYSICAL THERAPY

Individual provider Active NPI Physical Therapist · Montgomery, IL

NPI 1124950993 · NPPES record last updated Jun 12, 2026

Key facts

NPI
1124950993
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
070.039887 (IL)
Practice address
1379 Sycamore LN
Montgomery, IL 60538-1453
Phone
(800) 770-6682
NPI assigned
Jun 3, 2026
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

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.

Medicare Care Compare profile

Specialty
Physical Therapist in Private Practice
Education
Other, 2026
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1420 W 18TH St
Chicago, IL 60608-3004

4714 Gettysburg Rd
Mechanicsburg, PA 17055-4325

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20260618000112 IL Practitioner - Physical Therapist in Private Practice 8426520636 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070.039887 IL Yes

Addresses

Primary practice location

1379 Sycamore LN
Montgomery, IL 60538-1453

Mailing address

1379 Sycamore LN
Montgomery, IL 60538-1453

Other providers in Montgomery, IL

All providers in Montgomery, IL · Physical Therapist in Illinois

Sources for this page

Verify at the official NPI Registry.