Individual
ANDREW MITCHELL PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
612 N 11TH ST, QUINCY, IL 62301-2662
(217) 224-9484
Mailing address
612 N 11TH ST, QUINCY, IL 62301-2662
(217) 224-9484
(217) 224-7950
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
125086238
IL
390200000X
Student in an Organized Health Care Education/Training Program
Primary
125086238
IL
Other
Enumeration date
06/11/2025
Last updated
02/02/2026
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