Individual
SELENA B PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
40 SKOKIE BLVD STE 300, NORTHBROOK, IL 60062-1601
(866) 729-1012
(847) 996-2147
Mailing address
40 SKOKIE BLVD STE 300, NORTHBROOK, IL 60062-1601
(866) 729-1012
(847) 996-2147
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
54751
WI
207LA0401X
Addiction Medicine (Anesthesiology) Physician
36166538
WI
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
36166538
WI
Other
Enumeration date
07/28/2006
Last updated
06/04/2024
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