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General NPI Number Information
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NPI Number | 1568997310
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Entity Type | Individual
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Provider Name | WILLIAM B PETERSON DPT
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Gender | Male
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Dates
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Enumeration Date | 04/28/2017
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Last Update Date | 06/28/2018
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Provider Practice Location Address
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Address Line | 777 N YORK RD STE 11
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City | HINSDALE
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State | IL
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Zip | 60521
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Country | US
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Telephone | 630-819-8384
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Fax | 630-468-0605
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Provider Business Mailing Address
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Address Line | PO BOX 220
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City | WESTMONT
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State | IL
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Zip | 60559-0220
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Country | US
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Telephone | 630-399-1015
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Fax | 708-469-4100
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 070023131
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License Number State | IL
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