Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
TIM PETERSEN
ActiveTIM PETERSEN is a Driver healthcare provider located in FAIRVIEW, Illinois. NPI 1689113680 is currently active in the NPPES registry. Verify at CMS.
Driver · FAIRVIEW, IL
Registration Details
- NPI Number
- 1689113680
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Feb 23, 2017 (9.5187907632358 yrs)
- Last Updated
- Feb 23, 2017
- License
-
P362-8106-6065 (IL)
Practice Information
- Address
-
32059 N STATE ROUTE 97FAIRVIEW, IL, 614329643Browse IL providers · Browse ZIP 61432
- Phone
- 3094142155
- Primary Specialty
-
Driver
172A00000X
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.