Individual ProviderMallory BoentePhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address2201 W White Oaks Dr, Springfield, IL 62704-6498(217) 546-3301PECOS EnrollmentBased on the most recent information from CMS, provider Mallory Boente does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1982080487Provider TypeIndividualFull NameBoente, MalloryCredentialPT, DPTGenderFemaleSole ProprietorYesEnumeration Date8/6/2015Last Updated1/15/2026Contact InformationPractice LocationPractice Address2201 W White Oaks Dr, Springfield, IL 62704-6498Phone(217) 546-3301FaxUnlisted FaxMailing LocationMailing Address2201 W White Oaks Dr, Springfield, IL 62704-6498Phone(217) 546-3301FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense070022276Illinois