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

Mida N Bautista-Dittmar, PT

Individual provider Physical Therapist · NPI 1982714010

Mida N Bautista-Dittmar, PT is a Physical Therapist in Private Practice in Peru, Illinois. Qualified in 1992, 34 years ago. Practices with City Center Rehabilitation West - Inc, a 4-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
34
Licensed in
IL
In the registry since
2006
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

1627 4th St
Peru, IL 61354-3507
Phone: (815) 223-4479
Fax: (815) 223-4489
Show map & directions

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

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 70007736 (IL)

Record details

NPI number1982714010
Entity typeIndividual (Type 1)
GenderFemale
Credentials PT
Sole proprietorNo
NPI enumeratedAugust 30, 2006
Last updated in NPPESJanuary 14, 2009

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 1992 (34 years in practice)
Group practice City Center Rehabilitation West - Inc. — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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