Susan M. Petter is a Pediatrics in Springfield, Illinois. Susan M. Petter practices all healthcare services and medical treatments related to Pediatrics. The NPI Number for Susan M. Petter is 1871566042. The last update date is 2007-07-08.
Susan M. Petter's current location address is 1221 Wickford Dr, Springfield, Illinois. You can contact this provider via phone number 2177933762 and fax number 2177933762. The mailing address for Susan M. Petter is 1221 Wickford Dr, Springfield, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Susan M. Petter |
|---|---|
| Address | 1221 Wickford Dr, Springfield, Illinois |
| Phone Number | 2177933762 |
| Fax Number | 2177933762 |
| Sole Proprietor | X |
| Credentials | P.T. |
NPI Number Detail
| NPI Number | 1871566042 |
|---|---|
| Provider Enumeration Date | 2006-02-08 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 1221 Wickford Dr |
|---|---|
| City | Springfield |
| State | Illinois (IL) |
| Post Code | 627042127 |
| Phone Number | 2177933762 |
| Fax Number | 2177933762 |
Provider's Primary Taxonomy Detail
| Speciality | Pediatrics |
|---|---|
| Taxonomy | 2251P0200X |
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Definition: A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Pediatric Physical Therapy, who has demonstrated specialized knowledge and skill in anatomy, histology, including embryonic development, |
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What is the unique 10-digit identification code issued to Susan M. Petter by the Centers for Medicare & Medicaid Services?
The Susan M. Petter has been assigned the NPI (National Provider Identifier) 1871566042 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you share the physical location details of Susan M. Petter?
The Susan M. Petter is situated at 1221 Wickford Dr, in the city of Springfield, state of IL, with the zip code 627042127.
What is Susan M. Petter's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Susan M. Petter is Pediatrics, and the taxonomy classification code that categorizes this area of expertise is 2251P0200X.
On what date did the Centers for Medicare & Medicaid Services assign the 1871566042 to Susan M. Petter?
The Centers for Medicare & Medicaid Services assigned the 1871566042 to Susan M. Petter on 2006-02-08.
As of what date were the Susan M. Petter's details last updated?
The information pertaining to the Susan M. Petter, including its address, specialty, and other details, was most recently updated on 2007-07-08.
NPI Number: 1215930425
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