Individual provider Active NPI

Amanda Lee Marsh, DPT

  • Physical Therapist
  • Forest Park, IL
National Provider Identifier
1740866714
Registry record updated Aug 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
109 Harlem Ave
Forest Park, IL 60130-1125
Phone
(708) 488-1408
Fax
(708) 488-1545
NPI assigned
Mar 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X
Physical Therapist 225100000X IL Primary

Addresses

Primary practice location

109 Harlem Ave
Forest Park, IL 60130-1125

Mailing address

2001 Butterfield Rd Ste 1600
Downers Grove, IL 60515-1211

Other practice location 1

3330 W 177th St Ste 2B
Hazel Crest, IL 60429-2186
Phone (708) 249-8347

Other practice location 2

727 SE Main St Ste 200
Simpsonville, SC 29681-3262
Phone (864) 454-6670

Other practice location 3

4947 Paysphere Circle
Chicago, IL 60674-3262
Phone (877) 284-2455

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210326001625 IL Practitioner - Physical Therapist in Private Practice 8527475128 Reassigns benefits to 1 organization
I20231024000318 SC Practitioner - Physical Therapist in Private Practice 8527475128 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greenville Proaxis Therapy LLCGroup PAC ID 0244267771, 221 clinicians

Practice addresses (Care Compare)

109 Harlem Ave
Forest Park, IL 60130-1125
Phone (708) 488-1408

727 SE Main St
Suite 200
Simpsonville, SC 29681-3262
Phone (864) 454-6670

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Greenville Proaxis Therapy, LLC Physical Therapist CurrentSince Aug 27, 2023 Accepting new patients
Greenville Proaxis Therapy LLC CurrentSince Aug 27, 2023 Accepting new patients
Prisma Health University Medical Group Past Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

33205 Collection Ctr Dr
Chicago, IL 60693

2001 Butterfield Rd
Ste 1600
Downers Grove, IL 60515

103 N Main St
Ste 201
Greenville, SC 29601
Phone (864) 528-5753

111 Doctors Dr
Greenville, SC 29605
Phone (864) 242-4683

1305 S Suber Rd
Greer, SC 29650
Phone (864) 989-4609

713 W Wade Hampton Blvd
Greer, SC 29650
Phone (864) 479-6084

727 SE Main St
Ste 200
Simpsonville, SC 29681
Phone (864) 454-6670

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1616371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755561600000",
    "number": "1740866714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 BUTTERFIELD RD STE 1600",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 HARLEM AVE",
            "city": "FOREST PARK",
            "state": "IL",
            "postal_code": "601301125",
            "telephone_number": "708-488-1408",
            "fax_number": "708-488-1545"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3330 W 177th St Ste 2B",
            "address_purpose": "LOCATION",
            "city": "Hazel Crest",
            "state": "IL",
            "postal_code": "604292186",
            "country_code": "US",
            "telephone_number": "708-249-8347",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "727 SE Main St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Simpsonville",
            "state": "SC",
            "postal_code": "296813262",
            "country_code": "US",
            "telephone_number": "864-454-6670",
            "fax_number": "864-454-6675",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4947 Paysphere Circle",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606743262",
            "country_code": "US",
            "telephone_number": "877-284-2455",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARSH",
        "first_name": "AMANDA",
        "middle_name": "LEE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-22",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2025; 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.