DR. JON FREDRICK PETERSEN M.D. NPI 1285621516

NPI Information

NPI: 1285621516
Provider Name: DR. JON FREDRICK PETERSEN, M.D.
Classification: Preventive Medicine - 2083X0100X
Entity Type: Individual

Specialization: Occupational Medicine

Address:
1750 E LAKE SHORE DR
DECATUR, IL
ZIP 62521
Phone: (217) 464-1440
Get Directions

DR. Jon Fredrick Petersen, M.D. is an occupational medicine preventive medicine in Decatur, IL. The provider is occupational medicine focuses on the health of workers, including the ability to perform work; the physical, chemical, biological, and social environments of the workplace; and the health outcomes of environmental exposures. Practitioners in this field address the promotion of health in the work place, and the prevention and management of occupational and environmental injury, illness, and disability. DR. Jon Fredrick Petersen, M.D. NPI is 1285621516. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1750 E LAKE SHORE DR
DECATUR, IL
ZIP 62521-803
Phone: (217) 464-1440
Fax: (217) 464-1469

The enumeration date for this NPI number is 10/3/2005 and was last updated on 10/12/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine		036129728	ILLINOIS	No
2	2083X0100X	Preventive Medicine	Occupational Medicine	036129728	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	141780003	MEDICARE PIN
2	250766	OTHER		HEALTHLINK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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