John T Peterson Dds Pc

LBN: John T Peterson Dds Pc
John T Peterson Dds Pc is an health care organization with primary practice located at 200 E Court St Suite 504, Kankakee IL 60901-3843. The organization recently has only one registered license in Dental Providers / Dentist, which is considered as the primary health care specialty. John T Peterson Dds Pc can be contacted via phone (815) 932-3613, or through Peterson, John T via phone (815) 932-3613.

Contact Information

Primary practice address
200 E Court St Suite 504 Kankakee IL 60901-3843
Phone: (815) 932-3613
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Peterson, John T Doctor of Dental Surgery (DDS)
Phone: (815) 932-3613

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 19A14762 Illinois

Profile Details

NPI number 1437436664
LBN Legal business name John T Peterson Dds Pc
DBA Doing business as
Authorized official Peterson, John T Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Nov 16th, 2011
Last updated Nov 16th, 2011 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437436664 NPPES
Illinois MEDICAID 1003311
Illinois Other 606970
Illinois Other 021076

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