Individual
KEVIN PATRICK PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2003 KOOTENAI HEALTH WAY STE 300, COEUR D ALENE, ID 83814-6051
(208) 625-5081
Mailing address
4309 W MEDICAL CENTER DR STE A200, MCHENRY, IL 60050-8437
(815) 759-8070
(815) 759-4931
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085006652
IL
363AS0400X
Surgical Physician Assistant
PA-2280
ID
Other
Enumeration date
07/23/2018
Last updated
07/22/2025
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