Peterson, John

Peterson, John is an sole proprietor health care provider with primary practice located at 2917 Crossing Ct Suite B1, Champaign IL 61822-6184. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Addiction Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Peterson, John can be contacted via phone (217) 344-2740.

Contact Information

Primary practice address
2917 Crossing Ct Suite B1 Champaign IL 61822-6184
Phone: (217) 344-2740
Fax: (217) 344-2819
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 036083081 Illinois
Allopathic & Osteopathic Physicians / Addiction Medicine 207RA0401X 036083081 Illinois
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 036083081 Illinois

Profile Details

NPI number 1003833625
LBN Legal business name Peterson, John
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 17th, 2006
Last updated Mar 16th, 2019 - about 6 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1003833625 NPPES
Illinois MEDICAID 036083081

Popular Providers