MEDICARE: DR. JERAMIE LEE BUTTS PHYSICAL THERAPY

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	070.039887	IL

General Provider Information

NPI Number	:	1124950993
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JERAMIE LEE BUTTS PHYSICAL THERAPY

Provider Business Mailing Address
First Line	:	1379 SYCAMORE LN
Second Line	:
City	:	MONTGOMERY
State	:	IL
Zip	:	60538-1453
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1379 SYCAMORE LN
Second Line	:
City	:	MONTGOMERY
State	:	IL
Zip	:	60538-1453
Country	:	US
Telephone Number	:	800-770-6682
Fax Number	:

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

Provider Enumeration Date	:	06/03/2026
Last Update Date	:	06/12/2026

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