| Ann Marie Peterson, Llc | |
|
6408 Briarcliff Ct Lisle IL 60532-4204 | |
| (630) 909-3781 | |
| Not Available |
| Full Name | Ann Marie Peterson, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 6408 Briarcliff Ct, Lisle, Illinois |
| Authorized Official Name and Position | Ann Marie Peterson (OWNER) |
| Authorized Official Contact | 6309093781 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ann Marie Peterson, Llc 6408 Briarcliff Ct Lisle IL 60532-4204 Ph: (630) 909-3781 | Ann Marie Peterson, Llc 6408 Briarcliff Ct Lisle IL 60532-4204 Ph: (630) 909-3781 |
| NPI Number | 1255820734 |
|---|---|
| Provider Enumeration Date | 05/09/2018 |
| Last Update Date | 08/02/2022 |
| Certification Date | 08/02/2022 |
| Medicare PECOS PAC ID | 1355696931 |
|---|---|
| Medicare Enrollment ID | O20180622001056 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255820734 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Ann Marie Peterson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942639562 PECOS PAC ID: 0749579209 Enrollment ID: I20160523001890 |
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