Active NPI
Jeanne Peterson, DPT
- Physical Therapist
- Skokie, IL
National Provider Identifier
1346253382
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 70015051
- Practice address
- 8833 Gross Point Rd
Skokie, IL 60077-1859 - Phone
- (847) 674-2630
- Fax
- (847) 674-4042
- NPI assigned
- Aug 14, 2006
- Sex
- Female
- 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 | 70015051 | IL | Primary |
Addresses
Primary practice location
8833 Gross Point Rd
Skokie, IL 60077-1859
Mailing address
3107 N Southport Ave
#2
Chicago, IL 60657-3223
Phone (773) 610-5252
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 70015051 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1346253382",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3107 N SOUTHPORT AVE",
"address_2": "#2",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606573223",
"telephone_number": "773-610-5252"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8833 GROSS POINT RD",
"city": "SKOKIE",
"state": "IL",
"postal_code": "600771859",
"telephone_number": "847-674-2630",
"fax_number": "847-674-4042"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "JEANNE",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "70015051",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Skokie, IL
Sources for this page
- 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.