Active NPI
Alyssa Nicole Petty, PT, DPT
- Physical Therapist
- Mount Prospect, IL
National Provider Identifier
1972185346
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070.025725
- Practice address
- 3 W Oxford PL
Mount Prospect, IL 60056-1024 - Phone
- (502) 287-2661
- NPI assigned
- Apr 26, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070.025725 | IL | Primary |
Addresses
Primary practice location
3 W Oxford PL
Mount Prospect, IL 60056-1024
Mailing address
3 W Oxford PL
Mount Prospect, IL 60056-1024
Phone (502) 287-2661
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070.025725 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1619395200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619395200000",
"number": "1972185346",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 W OXFORD PL",
"city": "MOUNT PROSPECT",
"state": "IL",
"postal_code": "600561024",
"telephone_number": "502-287-2661"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 W OXFORD PL",
"city": "MOUNT PROSPECT",
"state": "IL",
"postal_code": "600561024",
"telephone_number": "502-287-2661"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETTY",
"first_name": "ALYSSA",
"middle_name": "NICOLE",
"name_prefix": "Mrs.",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-26",
"last_updated": "2021-04-26",
"certification_date": "2021-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070.025725",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Prospect, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.