Individual
PETER P VIENNE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
936 W US ROUTE 6, MORRIS, IL 60450-8858
(815) 942-0525
(815) 942-3501
Mailing address
1860 PAYSHERE CIRCLE, CHICAGO, IL 60674
(630) 469-9200
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036082983
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020438
HEALTH ALLIANCE
IL
05
—
036082983
—
IL
01
—
259912
HEALTH LINK
IL
01
—
3229984
BCBS
IL
Enumeration date
06/20/2005
Last updated
02/02/2021
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