KEVIN PATRICK PETERS


Address: 5666 E State St, Rockford, IL 61108-2425
Phone: 8152662000

KEVIN PATRICK PETERS (NPI# 1326525304) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1326525304
Entity Type Individual
Full Name KEVIN PATRICK PETERS
Practice Address 5666 E State St
Rockford
IL 61108-2425
Mailing Address 7228 W Farwell Ave
Chicago
IL 60631-1145
Practice Telephone 8152662000
Mailing Telephone 7737240019
Enumeration Date 2018-07-23
Last Update Date 2018-07-23
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AS0400X Physician Assistant
Specialization: Surgical Technologist
085006652 IL Physician Assistants & Advanced Practice Nursing Providers

Other Providers KEVIN PETERS

NPI Name Taxonomy Address Enumeration
1043877103 Kevin Lee Peters Counselor 20 Ne 10th Ave, Portland, OR 97232-2916 2019-05-23
1083123038 Kevin Peters Nurse Practitioner 444 N Eola Rd Ste 110, Aurora, IL 60502-9619 2017-09-21

Office Location

Street Address 5666 E STATE ST
City ROCKFORD
State IL
Zip Code 61108-2425

Providers in the same location

NPI Name Taxonomy Address Enumeration
1508849209 Richard Emery Freeman Neurological Surgery 5666 E State St, Rockford, IL 61108-2425 2005-11-28
1881293348 Salman Nafees Nurse Anesthetist, Certified Registered 5666 E State St, Rockford, IL 61108-2425 2020-10-25
1346856424 Keely K Zunker Nurse Practitioner 5666 E State St, Rockford, IL 61108-2472 2020-09-23
1962026476 Angie Youssef Hernandez Student in an Organized Health Care Education/Training Program 5666 E State St, Rockford, IL 61108-2425 2020-06-01
1568085710 Kelsey Surowiec Student in an Organized Health Care Education/Training Program 5666 E State St, Rockford, IL 61108-2425 2020-05-22
1801415864 Kyle R Clark Physician Assistant 5666 E State St, Rockford, IL 61108-2425 2020-04-10
1508495144 Sadie Jae Pierce-mulligan 5666 E State St, Rockford, IL 61108-2425 2020-04-06
1376170183 Nicole Ann O'neill Dietitian, Registered 5666 E State St, Rockford, IL 61108-2425 2020-03-24
1447884804 Marissa Ann Giannangeli Occupational Therapist 5666 E State St, Rockford, IL 61108-2425 2020-02-25
1023659711 Erin R. Moody Physician Assistant 5666 E State St, Rockford, IL 61108-2425 2019-10-03
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1952862617 Isr Enterprises, Inc. Homemaker 129 Phelps Ave, Bldg 10, Ste 1008, Rockford, IL 61108 2019-03-26
1003306465 Adrienne Nicole Black Behavior Technician 519 Woodland Dr, Woodland Dr, Rockford, IL 61108 2018-05-11
1184085201 Integrative Healing Center, LLC Clinic/Center 6019 Fincham Drive, Rockford, IL 61108 2016-03-17
1730547936 Perryville Dentist PC Dentist 845 S Perryville Rd, Unit 119, Rockford, IL 61108 2016-02-02
1023489853 Nicole Ping Ticknor Counselor 433 S. Phelps Ave., Suite 2, Rockford, IL 61108 2015-10-20
1275940348 Northwest Home Care, Inc. Home Health 1437 S. Bell School Road, Suite 7, Rockford, IL 61108 2014-07-21
1487072922 Alecia Greenlee Psychiatry & Neurology Rosecrance Community Mental Health, 3815 Harrison Avenue, Rockford, IL 61108 2014-04-02
1871925446 Maria Laura Gustafson Interpreter 3208 Wesleyan Ave., Rockford, IL 61108 2013-08-06
1346582822 Joseph Peevey Pathology 5666 E State Street, Department of Pathology, Rockford, IL 61108 2013-03-21
1134466923 James Henry Peck Hearing Instrument Specialist 2424 Charles St, Rockford, IL 61108 2013-01-14
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Taxonomy Information

Taxonomy Code 363AS0400X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Surgical Technologist

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1598217168 Cindy Giurgiu Physician Assistant 5666 E State St, Rockford, IL 61108-2425 2016-10-31
1447682703 Patrick Hoffmann Physician Assistant 5666 E State St, Rockford, IL 61108-2425 2013-08-08
1720286206 Neurex Pllc Physician Assistant 1491 Stony Creek Way, Apt 2, Rockford, IL 61108-1210 2007-07-06
1629177647 Daniel A Bentley Physician Assistant 1401 E State St, Rockford, IL 61104-2315 2006-09-22

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1477169522 Priority Assist Pllc Physician Assistant 48 Glenda Ln, Plano, IL 60545-9652 2020-09-23
1154944478 Diana Goldak Physician Assistant 3855 N Parkway Dr Apt 3a, Northbrook, IL 60062-7218 2020-05-20
1033742580 Colleen Courtney Physician Assistant 218 S Driftwood Trl, Mchenry, IL 60050-5454 2020-02-12
1326678962 Nina Kodros Physician Assistant 301 Madison St Ste 280, Joliet, IL 60435-6672 2020-01-23
1689218190 Jennifer Richman Physician Assistant 1890 Silver Cross Blvd Ste 410, New Lenox, IL 60451-9547 2019-10-29
1710547625 Nadia Khan Physician Assistant 4543 N Malden St Apt 1s, Chicago, IL 60640-5687 2019-06-13
1962065516 Jorge Mantilla Physician Assistant 5540 N Kimball Ave Apt 3e, Chicago, IL 60625-4674 2019-04-18
1013479955 Leah Rae Prager Physician Assistant 4400 W. 95th St., Attn: Pediatric General Surgery, Oak Lawn, IL 60453 2019-04-01
1770041949 Laura Ann Ryan Physician Assistant 840 S Wood St Ste 417, Chicago, IL 60612-4325 2019-03-06
1548739782 Helen Finke Physician Assistant 880 W Central Rd Ste 3300, Arlington Heights, IL 60005-2366 2018-11-16
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Competitor

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City ROCKFORD
Zip Code 61108

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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