Individual provider Active NPI

Shauna Peterson, BS

  • Physical Therapist
  • Aurora, IL
National Provider Identifier
1881735769
Registry record updated Nov 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070008939 Issued in IL
Practice address
1137 N Eola Rd
Suite 106
Aurora, IL 60502-7096
Phone
(630) 236-6698
Fax
(630) 236-6856
NPI assigned
Feb 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070008939 IL Primary

Addresses

Primary practice location

1137 N Eola Rd
Suite 106
Aurora, IL 60502-7096

Mailing address

1820 W Main St
St Charles, IL 60174-1634
Phone (630) 762-1200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120725000247 IL Practitioner - Physical Therapist in Private Practice 3678739380 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

1820 W Main St
St Charles, IL 60174-1634
Phone (630) 762-1200

3865 E Main St
St Charles, IL 60174-2424
Phone (630) 587-5788

407 N Lagrange Rd
Lagrange Park, IL 60526-5623
Phone (708) 482-9320

722 N McLean Blvd
South Elgin, IL 60177-1429
Phone (847) 695-5088

Merit-based Incentive Payment System (MIPS)

Final score
86.32 of 100Reported as group
Quality
84.44
Promoting interoperability
99
Improvement activities
40
Cost
70.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Physical Therapist CurrentSince Jul 1, 2012 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Jul 1, 2012 Accepting new patients

Locations

1677 Montgomery Rd
Ste 102
Aurora, IL 60504
Phone (630) 947-7400

1137 N Eola Rd
Ste 106
Aurora, IL 60502
Phone (630) 236-6698

280 N Randall Rd
Lake in the Hills, IL 60156
Phone (847) 854-8219

625 Enterprise Dr
Oak Brook, IL 60523
Phone (630) 575-6250

722 N McLean Blvd
South Elgin, IL 60177
Phone (847) 695-5088

1820 W Main St
St Charles, IL 60174
Phone (630) 762-1200

Organizations & group practices 2

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": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259107200000",
    "number": "1881735769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1820 W MAIN ST",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601741634",
            "telephone_number": "630-762-1200",
            "fax_number": "630-762-1230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1137 N EOLA RD",
            "address_2": "SUITE 106",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605027096",
            "telephone_number": "630-236-6698",
            "fax_number": "630-236-6856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "SHAUNA",
        "credential": "BS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-12",
        "last_updated": "2009-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070008939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2009; 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.