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General NPI Number Information
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NPI Number | 1588785380
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Entity Type | Organization
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Legal Business Name | PETERSON OCCUPATIONAL HEALTH SERVICES, SC
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 06/17/2008
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Provider Practice Location Address
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Address Line | 2300 W PETERSON AVE
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City | CHICAGO
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State | IL
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Zip | 60659-5203
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Country | US
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Telephone | 773-508-9800
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Fax | 773-508-1796
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Provider Business Mailing Address
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Address Line | 2320 W PETERSON AVE
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City | CHICAGO
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State | IL
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Zip | 60659-5242
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Country | US
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Telephone | 773-508-9800
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Fax | 773-508-1796
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Authorized Official
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Title or Position | OWNER
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Name | DR. AREF SENNO
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Credential | M.D.
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Telephone | 773-508-9800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number |
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License Number State |
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