Update this page – If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS.
Organization
PETERSON CHIROPRACTIC, PC
Active
Organization
PETERSON CHIROPRACTIC, PC
Active
Other names
Great Lakes Health & Wellness, SC
Organization subpart
No
Provider details
NPI number
Authorized official
MARY PETERSON DC (PRESIDENT)
(708) 371-6114
Entity
Organization
Contact information
Practice address
8702 W 124TH ST, PALOS PARK, IL 60464-1828
(708) 371-6114
(708) 371-0816
Mailing address
8702 W 124TH ST, PALOS PARK, IL 60464-1828
(708) 371-6114
(708) 371-0816
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301007900
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0N94490
MEDICARE GROUP NUMBER
MI
Enumeration date
09/06/2007
Last updated
04/01/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up