Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. GLEN R PETERSON, D.C.
ActiveDR. GLEN R PETERSON, D.C. is a Sports Physician (Chiropractor) healthcare provider located in LA SALLE, Illinois. NPI 1437209418 is currently active in the NPPES registry. Verify at CMS.
Sports Physician (Chiropractor) · LA SALLE, IL
Registration Details
- NPI Number
- 1437209418
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 11, 2007 (19.407370780793 yrs)
- Last Updated
- Jul 8, 2007
- License
-
038-008373 (IL)
Practice Information
- Address
-
501 1ST STLA SALLE, IL, 613012416Browse IL providers · Browse ZIP 61301
- Phone
- 8152234201
- Fax
- 8142234210
- Primary Specialty
-
Sports Physician (Chiropractor)
111NS0005X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.