Peters, Neill T

Peters, Neill T is an individual health care provider with primary practice located at 5525 S Pulaski Rd , Chicago IL 60629-4417. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Peters, Neill T can be contacted via phone (773) 585-1955.

Contact Information

Primary practice address
5525 S Pulaski Rd Chicago IL 60629-4417
Phone: (773) 585-1955
Fax: (773) 284-5268
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X Illinois

Profile Details

NPI number 1215912795
LBN Legal business name Peters, Neill T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 7th, 2005
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215912795 NPPES
Illinois MEDICAID 036095483 / 03
Illinois Other 01621679

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