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NPI Code Detail

MEDICARE: MRS. SUSAN M PETERS PT

MEDICARE: MRS. SUSAN M PETERS PT
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
1225100000XPhysical Therapist42839FL
2225100000XPhysical Therapist070006345IL

General Provider Information

NPI Number : 1245392489
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SUSAN M PETERS PT
Provider Business Mailing Address
First Line : 734 N ELMWOOD AVE
Second Line :
City : OAK PARK
State : IL
Zip : 60302-1728
Country : US
Telephone Number : 708-386-5019
Fax Number :
Provider Business Practice Location Address
First Line : 345 ASHLAND AVE
Second Line :
City : RIVER FOREST
State : IL
Zip : 60305-2109
Country : US
Telephone Number : 708-488-0072
Fax Number : 708-488-0084
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/14/2006
Last Update Date : 09/24/2025

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Directions to “ MRS. SUSAN M PETERS PT” Practice Location

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