Mary Peterson, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038.008605 Issued in IL

Practice address

7250 W College Dr
Suite 1SW
Palos Heights, IL 60463-1151

Phone

(708) 371-6114

Fax

(708) 371-0816

NPI assigned

Nov 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI, IL2 enrollments

Enrollment records 2

Specialty

Chiropractic

Education

National College of Chiropractic, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Palos Community Hospital Hospital, Palos Heights, IL, CCN 140062

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 and National Provider Directory roles.

• Great Lakes Health & Wellness,SC

  • Durable Medical Equipment & Medical Supplies
  • Palos Heights, IL
  • NPI 1831351873

  Chiropractor

  Medicare reassignment NPD Authorized official
• Sanders Chiropractic Inc.

  dba Great Lakes Health & Wellness

  • Chiropractor
  • Grand Haven, MI
  • NPI 1215169214
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Palos Community Hospital

  • Psychiatric Hospital Unit
  • Palos Heights, IL
  • NPI 1184699118
  Care Compare affiliation
• Palos Community Hospital

  • General Acute Care Hospital
  • Palos Heights, IL
  • NPI 1851386692
  Care Compare affiliation

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669939200000",
    "number": "1538233176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7250 W COLLEGE DR",
            "address_2": "SUITE 1SW",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631151",
            "telephone_number": "708-371-6114",
            "fax_number": "708-371-0816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7250 W COLLEGE DR",
            "address_2": "SUITE 1SW",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631151",
            "telephone_number": "708-371-6114",
            "fax_number": "708-371-0816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "MARY",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301007900",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104556711",
            "primary": false
        },
        {
            "code": "224L00000X",
            "taxonomy_group": "",
            "desc": "Pedorthist",
            "state": "IL",
            "license": "212.000204",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.008605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "950G010660",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joanna Perez, APRN, CNP
• Peter J. McDonnell M.D. SC
• Peter McDonnell MD, LLC
• Constantine G Peters, D.O.
• Bradford G Peterson, M.D.
• Theresa Pham, D.D.S.
• Phe Skilled Nursing Facility LLC (Avantara Palos Heights)
• PHW Skilled Nursing Facility LLC (Harmony Palos)
• Physician Diagnostic and Pathology (Associated Urological Spec)
• Physiotherapy Associates Inc (The Pediatric Place)

• Chiropractor in Palos Heights, IL
• Providers in Palos Heights, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2022; 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.