Healthcare Provider Details

I. General information

NPI: 1588785380
Provider Name (Legal Business Name): PETERSON OCCUPATIONAL HEALTH SERVICES, SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2007
Last Update Date: 06/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 W PETERSON AVE
CHICAGO IL
60659-5203
US

IV. Provider business mailing address

2320 W PETERSON AVE
CHICAGO IL
60659-5242
US

V. Phone/Fax

Practice location:
  • Phone: 773-508-9800
  • Fax: 773-508-1796
Mailing address:
  • Phone: 773-508-9800
  • Fax: 773-508-1796

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. AREF SENNO
Title or Position: OWNER
Credential: M.D.
Phone: 773-508-9800