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Ian Petersen, ATC-L
NPI 1255305850 · on the registry since 2006
Practice
- Address
- 345 Taft Road
South Holland, IL 60473 - Phone
- (708) 596-0107
- Fax
- (708) 671-0767
Registry record
- Primary taxonomy
- 2255A2300X
2255A2300X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2007-11-26
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois