DR. GAIL PETERSON (NPI# 1629058904) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629058904 |
| Entity Type | Individual |
| Full Name | DR. GAIL PETERSON |
| Credential | PH.D. |
| Practice Address |
1400 N Wood Rd Milwood Executive Suites Murphysboro IL 62966-6290 |
| Mailing Address |
Po Box 443 Carbondale IL 62903-0443 |
| Practice Telephone | 6185294988 |
| Practice Fax Number | 6183511419 |
| Mailing Telephone | 6185294988 |
| Mailing Fax Number | 6183511419 |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2013-07-03 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
2006006592 | MO | Behavioral Health & Social Service Providers |
| Y | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
071-002561 | IL | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE CROSS/ BLUE SHIELD | 03972011 | 01 |
| IL | HEALTH ALLIANCE MEDICAL PLANS | 27485 | 01 |
| IL | HEALTHLINK PROVIDER # | 126480 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114355757 | Gail Ingra Peterson | Counselor | 3043 S Meridian Rd, Suite 125, Meridian, ID 83642-7922 | 2013-10-16 |
| 1194987271 | Gail Peterson | Counselor | English Road Psychotherapy, 1800 English Road, Rochester, NY 14616 | 2008-06-30 |
| 1194739250 | Gail E Peterson | Dentist | 2526 Central Ave, Columbus, IN 47201-3121 | 2006-07-27 |
| 1598195778 | Gail Peterson | Registered Nurse | 100 Polk County Plz, Suite 180, Balsam Lake, WI 54810-9071 | 2013-11-25 |
| 1841381068 | Gail A. Peterson | Nurse Practitioner | 411 Fortuyn Rd, Grand Coulee, WA 99133-8718 | 2006-09-27 |
| 1447215256 | Gail Elizabeth Peterson | Internal Medicine | 5323 Harry Hines Blvd, Dallas, TX 75390-7208 | 2006-04-18 |
| Street Address |
1400 N WOOD RD MILWOOD EXECUTIVE SUITES |
| City | MURPHYSBORO |
| State | IL |
| Zip Code | 62966-6290 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538590187 | Hearing Enhancement LLC | Hearing Aid Equipment | 1400 N Wood Rd, Suite 8, Murphysboro, IL 62966-6290 | 2013-12-09 |
| 1275660433 | Roy H. Joy | Psychologist | 1400 N Wood Rd, Milwood Executive Suites, Murphysboro, IL 62966-6290 | 2007-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093272999 | Lifenet, Inc. | Ambulance | 430 N Airport Rd, Murphysboro, IL 62966 | 2019-02-27 |
| 1538678354 | Anita Tallegien Daneshdoost | Physical Therapist | 1725 Shomaker Drive, Murphysboro, IL 62966 | 2017-09-25 |
| 1295281558 | Alternatives Counseling Inc. | Community/Behavioral Health | 1400 N Wood Road, Murphysboro, IL 62966 | 2016-08-28 |
| 1962855833 | Andrea Maren Whipple | Counselor | 617 Walnut St, Murphysboro, IL 62966 | 2016-07-15 |
| 1730544180 | Lasharon Smith | Non-emergency Medical Transport (VAN) | 37 Nins Lane, Murphysboro, WI 62966 | 2015-12-29 |
| 1710241328 | Kati K Rush | Podiatrist | 19 E Shawnee Dr Ste 3, Murphysboro, IL 62966 | 2012-06-28 |
| 1386709418 | Hoai P Nguyen | Dentist | 1116 Locust Street, Murphysboro, IL 62966 | 2006-12-27 |
| 1154416576 | Hayley Autumn Hood | Occupational Therapist | 6 East Shawnee, Murphysboro, IL 62966 | 2006-10-03 |
| 1356435135 | Southern Illinois Hospital Services | General Acute Care Hospital | 2 South Hospital Drive, Murphysboro, IL 62966 | 2006-10-03 |
| 1699879825 | Stephen Craig Mills | Chiropractor | 1010 N 14th St, Murphysboro, IL 62966 | 2006-09-08 |
| Find all providers in zip 62966 | ||||
| Taxonomy Code | 103TB0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Cognitive & Behavioral |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871783191 | Gina Derosa Warren | Psychologist | 11 Westwood Ln, Murphysboro, IL 62966-3004 | 2007-08-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194330993 | Colibri Counseling | Psychologist | 4872 N Kenmore Ave Apt 1, Chicago, IL 60640-3726 | 2020-09-09 |
| 1427661685 | Peace of Mind Psychological Services Inc | Psychologist | 738 E Dundee Rd # 267, Palatine, IL 60074-2858 | 2020-08-27 |
| 1558974873 | Kelly Hamoudah | Psychologist | 945 W George St Ste 210, Chicago, IL 60657-5876 | 2020-08-26 |
| 1407479447 | Richard J Landau | Psychologist | 913 W Van Buren St Apt 5c, Chicago, IL 60607-3528 | 2020-05-26 |
| 1699394890 | Peter Platten | Psychologist | 4444 N Campbell Ave Apt 1s, Chicago, IL 60625-3076 | 2020-04-09 |
| 1750917571 | Anxiety Clinic of Evanston, LLC | Psychologist | 4604 W Patterson Ave, Chicago, IL 60641-3609 | 2020-03-13 |
| 1851923759 | Professional Family Solutions | Psychologist | 501 N Riverside Dr Ste 207, Gurnee, IL 60031-5918 | 2020-02-07 |
| 1841830338 | Modern Me Psychology, Inc. | Psychologist | 390 E Devon Ave Ste 201, Roselle, IL 60172-1763 | 2020-01-13 |
| 1326682501 | June Care LLC | Psychologist | 185 S Pleasant Rd, Lake Zurich, IL 60047-2240 | 2019-10-31 |
| 1063067866 | Shore Therapy Center for Wellness, LLC | Psychologist | 3330 Old Glenview Rd Ste 16, Wilmette, IL 60091-2963 | 2019-08-08 |
| Find all providers with the same taxonomy | ||||
| City | MURPHYSBORO |
| Zip Code | 62966 |
Please comment or provide details below to improve the information on DR. GAIL PETERSON.
| 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.