DR. MICHAEL J PETERSEN (NPI# 1518974153) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518974153 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL J PETERSEN |
| Credential | MD |
| Practice Address |
3922 Mercy Dr Mchenry IL 60050-3151 |
| Practice Telephone | 8153444499 |
| Mailing Telephone | 8153444499 |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | IL | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 016002938 1 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740602960 | Michael Petersen | Veterinarian | 5754 Nicollet Ave, Minneapolis, MN 55419-2415 | 2014-01-07 |
| 1407902307 | Michael James Petersen | Dentist | 3101 Old Highway 8, Suite #303, Roseville, MN 55113-1072 | 2007-01-25 |
| 1881798379 | Michael Charles Petersen | Pediatrics | 12356 Riata Trace Pkwy # 6006-b, Austin, TX 78727-6417 | 2006-09-12 |
| 1629005160 | Michael R Petersen | Ophthalmology | 2000 N Huron River Dr Ste 100, Ypsilanti, MI 48197 | 2006-06-28 |
| 1467428656 | Michael S Petersen | Orthopaedic Surgery | 2020 Sutter Pl, Suite 104, Davis, CA 95616-6213 | 2006-02-27 |
| 1609849736 | Michael T Petersen | Anesthesiology | 25 Main Pl, Suite 425, Council Bluffs, IA 51503-0792 | 2006-02-09 |
| 1639785579 | Michael Lee Petersen | Pharmacist | 900 W Clairemont Ave, Eau Claire, WI 54701-6122 | 2020-09-16 |
| 1780248146 | Michael Jake Petersen | Student in an Organized Health Care Education/Training Program | 600 S Paulina St Ste 403, Chicago, IL 60612-3806 | 2019-04-30 |
| 1093182552 | Michael Petersen | Counselor | 1067 E Tabernacle St, Suite 7, Saint George, UT 84770-3163 | 2015-08-31 |
| 1972746931 | Michael G Petersen | Physician Assistant | 7201 Manchaca Rd, Ste B, Austin, TX 78745-5283 | 2009-04-07 |
| Street Address |
3922 MERCY DR |
| City | MCHENRY |
| State | IL |
| Zip Code | 60050-3151 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801895545 | Abby C. Von Heimburg | Emergency Medicine | 3922 Mercy Dr, Mchenry, IL 60050-3179 | 2005-07-15 |
| 1366984783 | Lauren E. Loback | Physical Therapy Assistant | 3922 Mercy Dr, Mchenry, IL 60050-3179 | 2016-11-16 |
| 1609263110 | Jill L Ritzman | Occupational Therapist | 3922 Mercy Dr, Mchenry, IL 60050-3179 | 2015-04-22 |
| 1760882542 | Susan Mercado | Physical Therapist | 3922 Mercy Dr, Mchenry, IL 60050-3179 | 2014-08-28 |
| 1790117422 | Caitlin S Rock | Audiologist | 3922 Mercy Dr, Mchenry, IL 60050-3179 | 2013-08-05 |
| 1831455021 | Velislava Valentinova Lozeva | Internal Medicine | 3922 Mercy Dr, Mchenry, IL 60050-3179 | 2012-04-02 |
| 1174818272 | Jakob Christopher Thorud | Podiatrist | 3922 Mercy Dr, Mchenry, IL 60050-3179 | 2011-06-16 |
| 1134436835 | Sarah C Al-salim | Audiologist | 3922 Mercy Dr, Mchenry, IL 60050-3151 | 2010-09-02 |
| 1467684613 | Maria Joy Wolff | Physical Therapist | 3922 Mercy Dr, Mchenry, IL 60050-3179 | 2009-08-20 |
| 1063637544 | Syed Ommar Hassan | Family Medicine | 3922 Mercy Dr, Mchenry, IL 60050-3179 | 2007-04-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932728003 | Tco Jv, LLC | Skilled Nursing Facility | 550 Ridgeview Drive, Mchenry, IL 60050 | 2020-04-09 |
| 1992274971 | Lisa Luedtke | Counselor | 5342 West Elm Street, Mchenry, IL 60050 | 2018-11-19 |
| 1013402825 | Fox Ridge Medical Associates, LLC | Internal Medicine | 3633 Municipal Dr, Mchenry, IL 60050 | 2018-06-25 |
| 1700387065 | Richard Stacy Birmantas | Speech-Language Pathologist | 6515 West Route 120, Mchenry, IL 60050 | 2018-02-22 |
| 1659888774 | Kathleen Mather | Speech-Language Pathologist | 3502 Washington St, Mchenry, IL 60050 | 2018-01-10 |
| 1891205605 | Delorean Mckinney | Psychologist | 4031 Dayton Ave, Mchenry, IL 60050 | 2017-10-06 |
| 1851810741 | Diana Park | Pharmacist | 2253 N. Richmond Rd., Mchenry, IL 60050 | 2017-09-12 |
| 1063931921 | Lauren M Young | Counselor | 4031 W. Dayton Street, Mchenery, IL 60050 | 2017-09-12 |
| 1376086264 | Elizabeth Kathleen Zacher | Social Worker | 4100 W Dayton Street, Mchenry, IL 60050 | 2016-11-23 |
| 1700332491 | Jasmine Elias | Social Worker | 4031 Dayton St, Mchenry, IL 60050 | 2016-09-01 |
| Find all providers in zip 60050 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073129763 | Podiatric Management Systems LLC | Podiatrist | 4310f W Crystal Lake Rd # F, Mchenry, IL 60050-4208 | 2020-09-18 |
| 1851399299 | Alan H Numbers | Podiatrist | 5435 Bull Valley Rd., Suite 102, Mchenry, IL 60050-2209 | 2005-07-11 |
| 1174818272 | Jakob Christopher Thorud | Podiatrist | 3922 Mercy Dr, Mchenry, IL 60050-3179 | 2011-06-16 |
| 1174728638 | Dr. Florence L. Peters, Dpm, LLC | Podiatrist | 4921 W Elm St, Mchenry, IL 60050-4020 | 2007-06-15 |
| 1053535047 | Florence Leah Peters | Podiatrist | 4921 W Elm St, Mchenry, IL 60050-0000 | 2007-04-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881200343 | Podiatric Management Systems LLC | Podiatrist | 1 S067 Summit Ave, Oakbrook Terrace, IL 60181 | 2020-09-21 |
| 1114533700 | Podiatric Management Systems LLC | Podiatrist | 537 W 31st St, Chicago, IL 60616-3294 | 2020-09-18 |
| 1306452099 | Podiatric Management Systems LLC | Podiatrist | 2 W Talcott Rd Ste 23, Park Ridge, IL 60068-5558 | 2020-09-18 |
| 1679187090 | Podiatric Management Systems LLC | Podiatrist | 5600 W Addison St Lowr 2ll, Chicago, IL 60634-4499 | 2020-09-02 |
| 1932742848 | Foot and Ankle Care & Associates, Ltd | Podiatrist | 3320 W 63rd St, Chicago, IL 60629-3317 | 2019-10-23 |
| 1437622966 | Tomasz Szmyd Dpm, PC | Podiatrist | 1500 E 67th St, Chicago, IL 60637-4427 | 2019-01-08 |
| 1689145898 | S Thomas Sehy D P M L L C | Podiatrist | 213 Nw 10th St Ste B, Fairfield, IL 62837-1219 | 2018-12-16 |
| 1548746761 | Jeremy Marchand | Podiatrist | 2751 W Winona St Rm Ap457, Chicago, IL 60625-2508 | 2018-07-11 |
| 1932693744 | Giovanni Incandela | Podiatrist | 700 E Algonquin Rd Unit 2313, Schaumburg, IL 60173-3835 | 2018-06-15 |
| 1508365529 | Podiatry of Arlington Heights, PC | Podiatrist | 8 N Dunton Ave, Arlington Heights, IL 60005-1426 | 2018-02-05 |
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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.