MEDICARE: JEREMY PACE DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	LPT-011585	AZ

General Provider Information

NPI Number	:	1881072809
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEREMY PACE DPT

Provider Business Mailing Address
First Line	:	625 ENTERPRISE DR
Second Line	:
City	:	OAK BROOK
State	:	IL
Zip	:	60523-8813
Country	:	US
Telephone Number	:	630-575-6250
Fax Number	:

Provider Business Practice Location Address
First Line	:	37200 N GANTZEL RD STE 260
Second Line	:
City	:	QUEEN CREEK
State	:	AZ
Zip	:	85140-7387
Country	:	US
Telephone Number	:	480-690-8080
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2015
Last Update Date	:	04/08/2025

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