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Kelissa Peterson, DMD
NPI 1861047284 · on the registry since 2019
Practice
- Address
- 318 N Bloomington St
Streator, IL 61364 - Phone
- (815) 672-2647
- Fax
- (815) 672-5201
- Clinicians at this address
- 4
Registry record
- Primary taxonomy
- General Practice Dentistry
1223G0001X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2019-08-02
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