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Individual

MR. MICHAEL ROBERT PEFFER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
1014 EKSTAM DR STE 104, BLOOMINGTON, IL 61704-6382
(309) 661-0414
(309) 661-8697
Mailing address
118 WESTSHORE DR, MORTON, IL 61550-1315
(309) 397-4134

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038-006953
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5732069
BLUE CROSS BLUE SHIELD
IL
Enumeration date
07/14/2006
Last updated
09/28/2017
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