Individual
MICHAEL PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
660 N WESTMORELAND RD, LAKE FOREST, IL 60045-1659
(847) 535-5917
(847) 535-5801
Mailing address
75 REMITTANCE DR, SUITE 1951, CHICAGO, IL 60675-1001
(847) 535-5917
(847) 535-5801
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
36-091036
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036091036
—
IL
Enumeration date
01/11/2006
Last updated
03/24/2010
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