Molly Peterson, PT, DPT

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

070.024448 Issued in IL

Practice address

600 W Roosevelt Rd
Chicago, IL 60607-4912

Phone

(312) 588-5050

NPI assigned

Aug 7, 2019

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: mollypeterson@imaginepeds.com

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

{
    "created_epoch": "1565136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565136000000",
    "number": "1881249795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2028 N SHEFFIELD AVE APT 2R",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606144208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W ROOSEVELT RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606074912",
            "telephone_number": "312-588-5050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "MOLLY",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-07",
        "last_updated": "2019-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "IL",
            "license": "070.024448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Mollypeterson@imaginepeds.com",
            "affiliation": "N",
            "address_1": "600 W Roosevelt Rd",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606074912",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kyle S Peterson, RN
• Lisa Peterson, LMFT
• Loann Peterson, MD
• Mara Berenice Peterson, RN
• Mary-Margaret Peterson, LSW
• Paloma Carolina Peterson, LCSW
• Sara E Peterson, CRNA
• Sarah J Peterson, MS, RD
• Shankar Peterson
• Sophie Rose Peterson

• Pediatric Physical Therapist in Chicago, IL
• Providers in Chicago, IL by specialty
• Pediatric Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2019; 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.