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Individual

JOHN PETERSON

Active
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Individual

JOHN PETERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
036083081
IL
207R00000X
Internal Medicine Physician
Primary
036083081
IL
207RA0401X
Addiction Medicine (Internal Medicine) Physician
036083081
IL

Other

Enumeration date
07/17/2006
Last updated
03/16/2019
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