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General NPI Number Information
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NPI Number | 1003271586
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Entity Type | Individual
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Provider Name | ANGELA OBONDO PETERSON APRN, CNP
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Gender | Female
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Dates
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Enumeration Date | 12/28/2015
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Last Update Date | 11/11/2024
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Provider Practice Location Address
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Address Line | 25 N WINFIELD RD STE 500
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City | WINFIELD
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State | IL
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Zip | 60190-1379
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Country | US
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Telephone | 630-232-0280
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Fax | 630-232-3895
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Provider Business Mailing Address
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Address Line | 25 N WINFIELD RD STE 500
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City | WINFIELD
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State | IL
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Zip | 60190-1379
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Country | US
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Telephone | 630-232-0280
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Fax | 630-232-3895
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2017028749
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209025487
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License Number State | IL
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