DR. GLEN R PETERSON (NPI# 1437209418) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437209418 |
| Entity Type | Individual |
| Full Name | DR. GLEN R PETERSON |
| Credential | D.C. |
| Practice Address |
501 1st St La Salle IL 61301-2416 |
| Mailing Address |
Po Box 1204 La Salle IL 61301-3204 |
| Practice Telephone | 8152234201 |
| Practice Fax Number | 8142234210 |
| Mailing Telephone | 8152234201 |
| Mailing Fax Number | 8152234210 |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111NS0005X |
Chiropractor Specialization: Sports Physician |
038-008373 | IL | Chiropractic Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063444776 | Glen Allen Peterson | Chiropractor | 817 N Smithfield Rd, Knightdale, NC 27545-7717 | 2006-07-06 |
| 1508956186 | Glen Peterson | Nurse Practitioner | 12605 E 16th Ave, Aurora, CO 80045-2545 | 2006-10-13 |
| 1922196690 | Glen Francis Peterson | Dentist | 8721 Wadsworth Blvd, Suite #b, Arvada, CO 80003-0929 | 2006-10-10 |
| Street Address |
501 1ST ST |
| City | LA SALLE |
| State | IL |
| Zip Code | 61301-2416 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679883185 | Illinois Valley Chiropractic, Ltd | Chiropractor | 501 1st St, La Salle, IL 61301-2416 | 2010-10-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598912453 | Matthew V Hartman | Dentist | 941 First St, La Salle, IL 61301 | 2008-08-22 |
| 1164501078 | Pamela F Wolf | Counselor | 146 Gooding Street, La Salle, IL 61301 | 2006-11-02 |
| 1265514343 | Rose Mary Schaumberg | Nurse Practitioner | 2970 Chartres Street, Lasalle, IL 61301 | 2006-10-19 |
| 1578668141 | Cynthia L. Ashley | Psychologist | 206 Marquette Street, Suite 203, Lasalle, IL 61301 | 2006-09-14 |
| 1922016849 | Mary Therese Petrella | Nurse Practitioner | 2970 Chartres, Hygienic Institute Community Health Clinic, La Salle, IL 61301 | 2006-08-04 |
| 1073527461 | William L Judge | Chiropractor | 130 3rd St, La Salle, IL 61301 | 2006-07-28 |
| 1124044318 | North Central Behavioral Health Systems, Inc | Clinic/Center | 2960 Chartres St., Lasalle, IL 61301 | 2006-07-14 |
| 1962445247 | William Michael White | Dentist | 225 Gooding St, Suite 1, La Salle, IL 61301 | 2006-06-14 |
| 1730629429 | Liberty Kathleen Grzybowski | Social Worker | 2960 Chartres St., La Salle, IL 61301 | 2017-03-01 |
| 1619267135 | Gergovich Family Chiropractic, LLC. | Chiropractor | 130 3rd St, La Salle, IL 61301 | 2011-04-18 |
| Find all providers in zip 61301 | ||||
| Taxonomy Code | 111NS0005X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| Specialization | Sports Physician |
| A sports chiropractor is uniquely trained to provide care and treatment of injuries or illness resulting from sports and physical fitness activities. Doctors of Chiropractic with the Diplomate American Chiropractic Board of Sports Physicians (DACBSP) or the Certified Chiropractic Sports Physician (CCSP), sport specialty certifications from the American Chiropractic Board of Sports Physicians, have advanced training in the assessment, management and rehabilitation of sports related injuries. Extremity care, rehabilitation and soft tissue procedures are common skills utilized by these doctors. The specialty training covers a broad spectrum from the pediatric athlete to professional and Olympic athletes, and everything in between, using a variety of techniques and modalities. |
| Notes: Source: American Chiropractic Board of Sports Physicians, 2009 [7/1/2009: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679883185 | Illinois Valley Chiropractic, Ltd | Chiropractor | 501 1st St, La Salle, IL 61301-2416 | 2010-10-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114535531 | Dr. Carrie Skony, LLC | Chiropractor | 3080 Ogden Ave Ste 202, Lisle, IL 60532-1694 | 2020-07-22 |
| 1144684564 | Bradley Brunner | Chiropractor | 214 Rousch St, Lena, IL 61048-8822 | 2016-04-12 |
| 1972975464 | Loop Spine & Sports Center, Ltd. | Chiropractor | 30 N Michigan Ave Ste 605, Chicago, IL 60602-3806 | 2015-10-23 |
| 1437539400 | Loop Chiropractic & Sports Injury Center | Chiropractor | 19 S La Salle St, Suite 503, Chicago, IL 60603-1401 | 2015-06-04 |
| 1154689933 | Scott Family Chiropractic Clinic PC | Chiropractor | 4180 Rfd Ste 83, Suite 100, Long Grove, IL 60047-9580 | 2012-04-30 |
| 1891071114 | Nowicki Chiropractic Corporation | Chiropractor | 1841 Hicks Rd, Suite C, Rolling Meadows, IL 60008-1250 | 2011-11-01 |
| 1659652196 | Lauren Natalie Wills | Chiropractor | 1710 E 1st St, Sterling, IL 61081-2902 | 2011-08-29 |
| 1598055808 | Cherniak Family Chiropractic, PC | Chiropractor | 203 W Prairie St, Marengo, IL 60152-2136 | 2011-04-08 |
| 1356572564 | Josh Hover | Chiropractor | 8424 Skokie Blvd, Ste. 207, Skokie, IL 60077-2568 | 2009-08-05 |
| 1063685246 | Thomas Burton Sperry | Chiropractor | 2585 Ogden Ave, Downers Grove, IL 60515-1708 | 2008-04-08 |
| 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.