Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Moose Physical Therapy, PLLC

Organization Physical Therapist · NPI 1053927640

Moose Physical Therapy, PLLC is a Physical Therapist in Peoria, Illinois. Registered with an NPI since 2020.

In the registry since
2020
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

2000 W Pioneer Pkwy Ste 22
Peoria, IL 61615-5805
Phone: (309) 670-0853
Fax: (309) 279-5211
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X

Record details

NPI number1053927640
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jeremy Calame — Managing Member · (309) 670-0853
NPI enumeratedSeptember 18, 2020
Last updated in NPPESOctober 31, 2021
Certification dateOctober 31, 2021
Mailing address2000 W Pioneer Pkwy Ste 22, Peoria, IL 61615-5805

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