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

Jenelle Deatherage, PT

Individual provider Physical Therapist · NPI 1720090830

Jenelle Deatherage, PT is a Physical Therapist in Peoria, Illinois. Licensed in Illinois and Minnesota. Registered with an NPI since 2006.

Licensed in
IL, MN
In the registry since
2006
Specialties on file
2
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

9901 N Knoxville Ave Ste D
Peoria, IL 61615-1429
Phone: (309) 243-1989
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 070020706 (IL)
Physical Therapist Taxonomy 225100000X · Licence 7357 (MN)

Record details

NPI number1720090830
Entity typeIndividual (Type 1)
GenderFemale
Credentials PT
Sole proprietorNo
NPI enumeratedAugust 13, 2006
Last updated in NPPESJune 26, 2014

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