TIMOTHY JAMES PETERSON

CHICAGO, IL
NPI1497259360
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: IL  036.156545)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2018-03-23
Last Update Date2021-07-28
Business Address
TIMOTHY JAMES PETERSON MD
4630 S BISHOP ST
CHICAGO, IL 60609-3240
Phone number: 312-996-2000
Mailing Address
TIMOTHY JAMES PETERSON MD
2443 W LE MOYNE ST
CHICAGO, IL 60622-1720
Phone number: 262-894-0632