Individual
AUTUMN PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
360 N YORK ST, ELMHURST, IL 60126-2376
(630) 941-9299
Mailing address
117 S QUINCY ST, HINSDALE, IL 60521-3012
(715) 904-0080
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.036140
IL
Other
Enumeration date
06/23/2025
Last updated
06/23/2025
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