Individual
REBECCA M PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SA
Contact information
Practice address
19015 S JODI RD STE H, MOKENA, IL 60448-8534
(866) 787-4452
Mailing address
801 POLK AVE, DYER, IN 46311-1021
(708) 705-2042
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201168
NBSTSA
—
Enumeration date
07/06/2023
Last updated
07/06/2023
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