Tim Petersen
Driver · Fairview, IL
Practice location
32059 N State Route 97Fairview, IL 61432-9643
- Phone
- (309) 414-2155
NPI record
- NPI
- 1689113680
- Entity type
- Individual (Type 1)
- Enumeration date
- February 23, 2017
- Last updated
- February 23, 2017
- Sole proprietor
- No
Specialties & taxonomy codes
| Taxonomy | Code | License | State |
|---|---|---|---|
| Driver Primary | 172A00000X |
P362-8106-6065 | IL |
About Tim Petersen
Tim Petersen is a healthcare provider registered in the NPI registry with the primary taxonomy Driver (code 172A00000X). The practice location is 32059 N State Route 97, Fairview, IL 61432-9643. The NPI number 1689113680 was assigned on February 23, 2017 and the record was last updated on February 23, 2017.
Tim Petersen lists a license in the registry: #P362-8106-6065 (IL) for Driver. License numbers are self-reported to NPPES; verify them with the state licensing board.
Frequently asked questions
What is the NPI number of Tim Petersen?
The NPI number is 1689113680.
What is the phone number of Tim Petersen?
The phone number listed for the practice location is (309) 414-2155.
Where is Tim Petersen located?
32059 N State Route 97, Fairview, IL 61432-9643.
What is the taxonomy code for Tim Petersen?
The primary taxonomy code is 172A00000X – Driver.
Is this information correct?
All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.