Individual
DANIELLE MARIE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1740 W TAYLOR ST, CHICAGO, IL 60612-7232
(866) 600-2273
Mailing address
1405 MARKET ST, GOWRIE, IA 50543-7530
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036.160459
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/22/2019
Last updated
11/06/2023
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