Jesse Peterson, PHYSICAL THERAPIST

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

Practice address

222 S Riverside PLZ Ste 830
Chicago, IL 60606-5900

Phone

(866) 386-0773

NPI assigned

Mar 28, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Supplemental Health Care

  • Assisted Living Facility
  • Chicago, IL
  • NPI 1972827111
  NPD (past)

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174642136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5015 N HERMITAGE AVE # 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606402715",
            "telephone_number": "773-575-6563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 S RIVERSIDE PLZ STE 830",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606065900",
            "telephone_number": "866-386-0773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "JESSE",
        "name_prefix": "Mr.",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ethan E Peterson, DC
• Jack Peterson, BS
• Jade Peterson
• Jeffrey Carl Peterson, MD, PHD
• Jennifer Peterson, PMHNP
• Jessica Aretha Peterson, M.D.
• Jessica Kristen Peterson, M.D.
• Johna Peterson
• Joshua Garn Peterson, MD
• Kalena Peterson, PSYD., LP

• Physical Therapy Assistant in Chicago, IL
• Providers in Chicago, IL by specialty
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.