Individual
DR. ANTHONY RAY PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
3001 GREEN BAY RD, MAIL CODE 116A, NORTH CHICAGO, IL 60064-3048
(224) 610-4673
Mailing address
3001 GREEN BAY RD, MAIL CODE 116A, NORTH CHICAGO, IL 60064-3048
(224) 610-4673
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071006958
IL
Other
Enumeration date
07/26/2006
Last updated
05/29/2013
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