Provider Demographics
NPI:1851412266
Name:SIMS, PETER BENJAMIN (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:BENJAMIN
Last Name:SIMS
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3222 W LE MOYNE ST
Mailing Address - Street 2:#3E
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60651-2448
Mailing Address - Country:US
Mailing Address - Phone:847-644-5825
Mailing Address - Fax:773-384-4227
Practice Address - Street 1:3222 W LE MOYNE ST
Practice Address - Street 2:#3E
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60651-2448
Practice Address - Country:US
Practice Address - Phone:847-644-5825
Practice Address - Fax:773-384-4227
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist