Individual
DR. BRADLEY A PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
611 W. PARK STREET, EMERGENCY MEDICINE, URBANA, IL 61801
(217) 383-3313
(217) 383-4014
Mailing address
611 W PARK ST, BWPC, URBANA, IL 61801-2529
(217) 383-6792
(217) 383-4752
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036109503
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036-109503
—
IL
Enumeration date
04/24/2006
Last updated
05/08/2014
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