Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Jon Fredrick Petersen, MD

Individual provider Occupational Medicine Physician · NPI 1285621516

Dr. Jon Fredrick Petersen, MD is an Occupational Medicine Physician in Decatur, Illinois. Licensed in Illinois. Registered with an NPI since 2005.

Licensed in
IL
In the registry since
2005
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1750 E Lake Shore Dr
Decatur, IL 62521-3803
Phone: (217) 464-1440
Fax: (217) 464-1469
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Medicine Physician (primary) Taxonomy 2083X0100X · Licence 036129728 (IL)
Family Medicine Physician Taxonomy 207Q00000X · Licence 036129728 (IL)

Record details

NPI number1285621516
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedOctober 3, 2005
Last updated in NPPESOctober 12, 2016
Mailing address1750 E Lake Shore Dr, Decatur, IL 62521-3803

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