Peterson, John
Peterson, John is an sole proprietor health care provider with primary practice located at 2917 Crossing Ct Suite B1, Champaign IL 61822-6184. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Addiction Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Peterson, John can be contacted via phone (217) 344-2740.Contact Information
Primary practice address
2917 Crossing Ct Suite B1
Champaign IL 61822-6184
Phone: (217) 344-2740
Fax: (217) 344-2819
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 036083081 | Illinois |
| Allopathic & Osteopathic Physicians / Addiction Medicine | 207RA0401X | 036083081 | Illinois |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 036083081 | Illinois |
Profile Details
| NPI number | 1003833625 |
|---|---|
| LBN Legal business name | Peterson, John |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 17th, 2006 |
| Last updated | Mar 16th, 2019 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1003833625 | NPPES |
| Illinois | MEDICAID | 036083081 |
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