Jon R Petersen , LMT
Massage Therapist • Mchenry, IL
Notice of NPI Deactivation & Inactive Practice Status
According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Jon Petersen has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
Jon Petersen, LMT was a registered Massage Therapist practicing in Mchenry, IL. Throughout an active medical career spanning 18 years, Jon Petersen provided care at the practice location at 1307 COURT ST until profile deactivation on 2025-07-03.
Practice Location & Contact Primary Location
1307 Court St
Mchenry, IL 600504422
Specialty Benchmarks & Practice Insights
Comparative analytics for Massage Therapist in Mchenry, IL
Practicing in Mchenry, IL (1467 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
NUCC Taxonomy Code: 225700000X
An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
Record deactivated on July 03, 2025
NPI status registered as active in NPPES database
Registered at 1307 COURT ST, MCHENRY, IL 600504422 (Tel: 8153858190)
Registered at 1307 COURT ST, MCHENRY, IL 600504422 (Tel: 8153858190)
Recorded as JON PETERSEN, L.M.T.
Massage Therapist (License #227-000243 in IL)
First registered as active Individual Practitioner in NPPES Database.
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NPI Administrative Meta
Mailing Address
1307 Court St
Mchenry, IL 600504422
Phone: 8153858190
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