Individual
GIRELLE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
60 ORLAND SQUARE DR STE 101, ORLAND PARK, IL 60462-6522
(708) 914-5145
Mailing address
1293 TRINITY DR, CAROL STREAM, IL 60188-4354
(630) 550-6144
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085007005
IL
Other
Enumeration date
05/16/2019
Last updated
05/16/2019
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