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

Mallory Kirsch, DPT

Individual provider Physical Therapist · NPI 1891272597

Mallory Kirsch, DPT is a Physical Therapist in Private Practice in Mount Vernon, Illinois. Qualified in 2018, 8 years ago. Practices as a sole proprietor, works from 2 locations and accepts Medicare assignment. Licensed in South Carolina and Washington.

Years since qualifying
8
Licensed in
SC, WA
In the registry since
2018
Specialties on file
2
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

11545 E Radisson Rd
Mount Vernon, IL 62864-6861
Phone: (618) 316-3727
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1016 Tacoma Ave, Sunnyside, WA 98944-2263 — (509) 837-1760

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 60837937 (WA)
Physical Therapist Taxonomy 225100000X · Licence 9868 (SC)

Record details

NPI number1891272597
Entity typeIndividual (Type 1)
GenderFemale
Credentials DPT
Sole proprietorYes
NPI enumeratedJuly 25, 2018
Last updated in NPPESJuly 1, 2020
Certification dateJuly 1, 2020
Mailing address11545 E Radisson Rd, Mount Vernon, IL 62864-6861

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Mount Vernon