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Individual

GAIL L PETERMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RD

Contact information

Practice address
1006 S DIVISION ST, CARTERVILLE, IL 62918-1539
(618) 519-9200
(618) 985-3774
Mailing address
PO BOX 577, CARTERVILLE, IL 62918-0577
(618) 985-8221

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164001595
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
164001595
STATE LICENSE
IL
Enumeration date
08/22/2006
Last updated
09/16/2021
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