Russell N Petersen (NPI# 1164550620, PAC ID# 5698796449) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is CHIROPRACTIC.
| Nation Provider ID (NPI) | 1164550620 |
| PAC ID by PECOS | 5698796449 |
| Professional Enrollment ID | I20051208000626 |
| Full Name | Russell N Petersen |
| Organization Legal Name | CREEKSIDE CHIROPRACTIC AND REHABILITATION, LTD |
| Address |
4000 Enterprise Dr Sheboygan WI 53083-2245 |
| Phone Number | 9204599090 |
| Gender | M |
| Credential | DC |
| Medical School | PALMER COLLEGE CHIROPRACTIC - DAVENPORT |
| Graduation Year | 2004 |
| Primary Specialty | CHIROPRACTIC |
| Group Practice PAC ID | 8921029760 |
| Number of Group Practice Members | 3 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 4000 Enterprise Dr, Sheboygan, WI 53083-2245 | 9204599090 | CREEKSIDE CHIROPRACTIC AND REHABILITATION, LTD |
| Organization Legal Name | CREEKSIDE CHIROPRACTIC AND REHABILITATION, LTD |
| Physicians | 3 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jacob William Kornetzke | Chiropractic | Creekside Chiropractic and Rehabilitation, Ltd | 4000 Enterprise Dr, Sheboygan, WI 53083-2245 |
| Andrew Lee Tislau | Chiropractic | Creekside Chiropractic and Rehabilitation, Ltd | 4000 Enterprise Dr, Sheboygan, WI 53083-2245 |
| Street Address |
4000 ENTERPRISE DR |
| City | SHEBOYGAN |
| State | WI |
| Zip | 53083-2245 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jacob William Kornetzke | Chiropractic | Creekside Chiropractic and Rehabilitation, Ltd | 4000 Enterprise Dr, Sheboygan, WI 53083-2245 |
| Andrew Lee Tislau | Chiropractic | Creekside Chiropractic and Rehabilitation, Ltd | 4000 Enterprise Dr, Sheboygan, WI 53083-2245 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| David J Portmann | Chiropractic | Varish Chiropractic Clinics LLC | 516 S Wisconsin Dr, Howards Grove, WI 53083-1261 |
| Wendy L Varish | Chiropractic | Varish Chiropractic Clinics LLC | 516 S Wisconsin Dr, Howards Grove, WI 53083-1261 |
| Erik T Butzen | Chiropractic | Varish Chiropractic Clinics LLC | 516 S Wisconsin Dr, Howards Grove, WI 53083-1261 |
| Catherine M Best | Family Medicine | Aurora Medical Group Inc | 620 S Wisconsin Dr, Howards Grove, WI 53083-1263 |
| Abby M Safranski | Family Medicine | Aurora Medical Group Inc | 620 S Wisconsin Dr, Howards Grove, WI 53083-1263 |
| Kristie L Thieme | Optometry | David W Kisiolek Od Sc | 300 Audubon Rd, Howards Grove, WI 53083-1288 |
| David W Kisiolek | Optometry | David W Kisiolek Od Sc | 300 Audubon Rd, Howards Grove, WI 53083-1288 |
| Corinne S Beiersdorf | Optometry | David W Kisiolek Od Sc | 300 Audubon Rd, Howards Grove, WI 53083-1288 |
| Amy J Champlin | Physical Therapy | Sundance Rehabilitation LLC | 4221 Kadlec Dr, Sheboygan, WI 53083-1777 |
| Jennifer L Dulmes | Occupational Therapy | Sundance Rehabilitation LLC | 4221 Kadlec Dr, Sheboygan, WI 53083-1777 |
| Find all physicians in zip 53083 | |||
| City | SHEBOYGAN |
| Zip Code | 53083 |
| Specialty | CHIROPRACTIC |
| City + Specialty | SHEBOYGAN + CHIROPRACTIC |
Please comment or provide details below to improve the information on Russell N Petersen.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.