Petersen, Jon R

Petersen, Jon R is an sole proprietor health care provider with primary practice located at 1307 Court St , Mchenry IL 60050-4422. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist, which is considered as his primary health care specialty. Petersen, Jon R can be contacted via phone (815) 385-8190.

Contact Information

Primary practice address
1307 Court St Mchenry IL 60050-4422
Phone: (815) 385-8190
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist 225700000X 227-000243 Illinois

Profile Details

NPI number 1396937330
LBN Legal business name Petersen, Jon R
Credentials L.M.T.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 14th, 2007
Last updated May 10th, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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