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Petersen Health & Wellness, Llc

Petersen Health & Wellness, Llc is a health care provider in Peoria, IL. In this page you will find its mailing address, practice location, phone number, specialty etc.

physician-icon Basic Information

Practice Location 1203 Egyptian Trl, Tuscola, IL 61953-2050, US
Practice Location Phone217-253-4791
Practice Location Fax217-253-3754
Legal Business NamePETERSEN HEALTH & WELLNESS, LLC
NPI ?1609976869
Entity TypeOrganization
Enumeration Date ? Sep 25, 2006
Last Update Date ? Dec 27, 2017
Note:
NPI: National Provider Identifier issued to health care providers by Centers for Medicare and Medicaid Services (CMS).

specialty-icon Specialties & Licenses of Petersen Health & Wellness, Llc

SpecialtySpecializationLicenseLicense State
Skilled Nursing Facility 0046805Illinois

legacy-id-icon Legacy Provider IDs of Petersen Health & Wellness, Llc

Provider IdIssuer StateIssuer TypeIssuer
474213665001IllinoisMedicaid

official-icon Authorized Official of Petersen Health & Wellness, Llc

An authorized official is an appointed official with the legal authority to make changes and/or updates to the Petersen Health & Wellness, Llc's status and to commit the provider to fully abide by the laws and regulations relating to the National Provider Identifier (NPI).

Authorized Official Mark B. Petersen
Authorized Official Title/PositionPRESIDENT
Authorized Official Phone Number309-691-8113