PHYLLIS LEE PETERSON (PT CHT) – Physical Therapist, NPI 1629157508

PHYLLIS LEE PETERSON (PT CHT) is a healthcare provider. based in Bolingbrook, Illinois. specializing in Physical Therapist. They hold the professional credentials PT CHT. They hold a License No. 2590 (TN). The NPI Number for PHYLLIS LEE PETERSON (PT CHT) is 1629157508

Main info

Female
43 Years Of Experience
Accepts Medicare Assignment
Name
PHYLLIS LEE PETERSON (PT CHT)
NPI
1629157508
Phone
Not provided
Address
790 REMINGTON BLVD
Enumeration Date
3 November 2006
Last Update Date
14 September 2015

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4235591537
Graduation Year
1983 (43 years ago)
PAC ID
6305977117
Group Practice PAC ID
5294798336
Professional Enrollment ID
I20111031000149
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience57
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for PHYLLIS LEE PETERSON (PT CHT)

  • 790, Remington Boulevard, Bolingbrook, Will County, Illinois, 60440, United States

    BOLINGBROOK, IL 604404909

    Phone:

    Type: Mailing

  • 3112, North Ocoee Street, North Cleveland, Cleveland, Bradley County, East Tennessee, Tennessee, 37312, United States

    CLEVELAND, TN 37312

    Phone: (423) 559-1537

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60440)

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Provider's Procedures

PHYLLIS LEE PETERSON (PT CHT) performs procedures in Physical Therapist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICAL THERAPYTN97110Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes141364

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5294798336View full group profile
NameSpecialtyState
-GA
Physical Therapist In Private PracticeIL
Physical Therapist In Private PracticeGA
Physical Therapist In Private PracticeIL
Physical Therapist In Private PracticeAL
Physical Therapist In Private PracticeFL
Physical Therapist In Private PracticeTN
Physical Therapist In Private PracticeIL
Physical Therapist In Private PracticeIL
Physical Therapist In Private PracticeIL

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Frequently asked questions

Can I verify PHYLLIS LEE PETERSON (PT CHT) with an NPI only?
You can start verification with NPI 1629157508 for PHYLLIS LEE PETERSON (PT CHT), then check state licensing separately.
Does the file indicate PHYLLIS LEE PETERSON (PT CHT) is practicing under active NPI?
Directory data currently reports PHYLLIS LEE PETERSON (PT CHT) as active.
What is PHYLLIS LEE PETERSON (PT CHT)'s primary classification?
Physical Therapist is the headline specialty for PHYLLIS LEE PETERSON (PT CHT) here. Clinical services aligned with this taxonomy classification.
What address line appears for PHYLLIS LEE PETERSON (PT CHT)?
PHYLLIS LEE PETERSON (PT CHT)'s geographic hint is Bolingbrook, Illinois in our summary view.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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