Mackenzie Petersen, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070.027431 Issued in IL

Practice address

2943 W Jefferson St
Joliet, IL 60435-5235

Phone

(630) 920-4670

NPI assigned

Apr 17, 2026

Last updated

Apr 17, 2026By the provider in NPPES

Sex

Female

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

Specialty

Physical Therapist in Private Practice

Education

University of Michigan Medical School, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Premier Physical Therapy PC

  • Physical Therapist
  • Evergreen Park, IL
  • NPI 1336127117
  NPD

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

{
    "created_epoch": "1776384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776384000000",
    "number": "1467396572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 VILLAGE CENTER DR STE 205",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605274526",
            "telephone_number": "630-920-4670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2943 W JEFFERSON ST",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604355235",
            "telephone_number": "630-920-4670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "MACKENZIE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-17",
        "last_updated": "2026-04-17",
        "certification_date": "2026-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.027431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Perioperative Nursing Associates
• Steffany Kathleen Pershey
• D David Pesavento, OD
• Russell P Pesavento, DDS
• Kristin Peters, MA CCC-SLP
• Patricia Ann Petersen, FNP
• Lynette Peterson, COTA
• Jennifer Mary Petraitis, CRNA
• Vera Petras, MD
• Nicholas Petrus

• Physical Therapist in Joliet, IL
• Providers in Joliet, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.