Provider Demographics
NPI:1629189501
Name:PETERSEN, CLAUDIA F (MD)
Entity Type:Individual
Prefix:DR
First Name:CLAUDIA
Middle Name:F
Last Name:PETERSEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2501 COMPASS RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-8000
Mailing Address - Country:US
Mailing Address - Phone:847-901-5200
Mailing Address - Fax:847-904-4906
Practice Address - Street 1:2501 COMPASS RD
Practice Address - Street 2:SUITE 100
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60026-8000
Practice Address - Country:US
Practice Address - Phone:847-901-5200
Practice Address - Fax:847-904-4906
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-075631207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1912186024OtherGROUP NPI
216024OtherGROUP PTAN
1912186024OtherGROUP NPI
ILK48465Medicare PIN
ILE18687Medicare UPIN