TIM PETERSEN (NPI# 1689113680) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689113680 |
| Entity Type | Individual |
| Full Name | TIM PETERSEN |
| Practice Address |
32059 N State Route 97 Fairview IL 61432-9643 |
| Practice Telephone | 3094142155 |
| Mailing Telephone | 3094142155 |
| Enumeration Date | 2017-02-23 |
| Last Update Date | 2017-02-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 172A00000X | Driver | P362-8106-6065 | IL | Other Service Providers |
| Street Address |
32059 N STATE ROUTE 97 |
| City | FAIRVIEW |
| State | IL |
| Zip Code | 61432-9643 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225508807 | Jessica Allen | Social Worker | 905 Carter St, Fairview, IL 61432 | 2018-11-27 |
| 1013467430 | Jon Allen | Specialist/Technologist | 905 Carter St, Fairview, IL 61432-5036 | 2016-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154922094 | Leo Wilson | Technician | 403 Prospect Ave., Fairview, ND 59221 | 2020-11-06 |
| 1386243830 | Kevin Khoa Nguyen | Nurse Practitioner | 6028 Pine Valley Ln, Fairview, PA 16415-3272 | 2020-10-25 |
| 1649879719 | Rachel Elaine Thorpe | Behavior Technician | 6011 Pebble Creek Dr, Fairview, PA 16415-3263 | 2020-10-20 |
| 1609473172 | Amy Marie Errichetti | Nurse Practitioner | 1349 Upper Brush Creek Rd, Fairview, NC 28730-9217 | 2020-10-07 |
| 1588278113 | Brigitte Sullivan | Social Worker | 310 Grace Ave, Fairview, PA 16415-1445 | 2020-09-01 |
| 1336750256 | Ruby Jane Slamick | Technician | 4617 Daybrook Rd, Fairview, WV 26570-6118 | 2020-08-13 |
| 1346851466 | Amber Lynn Vantassell | Technician | 97 Miracle Run Rd, Fairview, WV 26570-6049 | 2020-08-12 |
| 1801407184 | Janet Gail Michael | Technician | 2253 Daybrook Rd, Fairview, WV 26570-8600 | 2020-08-11 |
| 1861003147 | Steven Puhalla | Technician | 72 Yank Hollow Rd, Fairview, WV 26570-8673 | 2020-08-11 |
| 1154930907 | Cynthia Hamilton | Case Manager/Care Coordinator | 27 Yank Hollow Rd, Fairview, WV 26570-8674 | 2020-07-28 |
| Find all providers in FAIRVIEW | ||||
| Taxonomy Code | 172A00000X |
| Grouping | Other Service Providers |
| Classification | Driver |
| A person employed to operate a motor vehicle as a carrier of persons or property. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265033179 | Nakiesha Walton | Driver | 807 Ridge Dr # 520, Dekalb, IL 60115-1385 | 2020-11-06 |
| 1679173025 | Victoria Williams | Driver | 853 N Highland Ave Ste C, Aurora, IL 60506-2218 | 2020-10-27 |
| 1669088175 | Robert D Smith | Driver | 7400 Timbercrest Dr, Godfrey, IL 62035-2894 | 2020-09-20 |
| 1104435551 | Oluwagbenga Afiamoye Ojo | Driver | 6969 N Ashland Blvd Unit 101, Chicago, IL 60626-3354 | 2020-07-30 |
| 1780216622 | David Woods | Driver | 802 Mountaineer Ln Apt C, Marion, IL 62959-4132 | 2020-02-09 |
| 1619508843 | Tywan Thompson | Driver | 1329 Coldspring Rd, Carol Stream, IL 60188-4713 | 2020-01-27 |
| 1437789732 | Ruby Nelson | Driver | 14429 S Emerald Ave, Riverdale, IL 60827-2618 | 2020-01-25 |
| 1861030009 | National Center for Economics | Driver | 300 Read St Ste B, Lockport, IL 60441-3265 | 2019-12-18 |
| 1811530769 | Safeway Transportation Services Corp | Driver | 550 N Green Bay Rd Ste 1, Waukegan, IL 60085-3183 | 2019-10-23 |
| 1912548611 | Best Transportation & Logistics | Driver | 11958 S Paulina St, Calumet Park, IL 60827-5316 | 2019-10-03 |
| Find all providers with the same taxonomy | ||||
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| 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.