Individual
MRS. CHERYL JO PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
2323 WINDISH DR, GALESBURG, IL 61401-9780
(309) 344-2323
(309) 344-4391
Mailing address
402 W MEMORIAL DR, ABINGDON, IL 61410-1021
(309) 221-5094
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
014-226592
IL
163WP0808X
Psychiatric/Mental Health Registered Nurse
014-226592
IL
171M00000X
Case Manager/Care Coordinator
014-226592
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
014-226592
DEPT PROF. REG
IL
01
—
370984175
F.I.N. CORP BRIDGEWAY
IL
Enumeration date
03/28/2007
Last updated
04/14/2009
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