Healthcare Provider Details

I. General information

NPI: 1750206801
Provider Name (Legal Business Name): REBECCA LYNN PELTZER-MILLER MSN, RN, CNL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 RIDGE AVE
EVANSTON IL
60202-3399
US

IV. Provider business mailing address

355 RIDGE AVE
EVANSTON IL
60202-3399
US

V. Phone/Fax

Practice location:
  • Phone: 847-316-4000
  • Fax:
Mailing address:
  • Phone: 847-316-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number041490558
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: