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Individual

EMILY PETERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MOT

Contact information

Practice address
1600 16TH ST, SUITE T14, OAK BROOK, IL 60523-1302
(630) 572-9700
(630) 572-0706
Mailing address
625 ENTERPRISE DR, OAK BROOK, IL 60523-8813
(630) 575-6250
(630) 575-7450

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056011756
IL
225X00000X
Occupational Therapist
31006351A
IN

Other

Enumeration date
10/05/2016
Last updated
05/09/2017
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