Individual
MRS. ANGELA SUE PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER A
Contact information
Practice address
642 INDIAN RIDGE DR, ANTIOCH, IL 60002
(847) 961-2875
Mailing address
642 INDIAN RIDGE DR, ANTIOCH, IL 60002-3102
(847) 961-2875
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
209-009096
IL
363LA2200X
Adult Health Nurse Practitioner
4674-33
WI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
277.000596
IL
Other
Enumeration date
10/29/2011
Last updated
08/11/2022
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