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

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1053069179

Nicholas John Peterman is a Student in an Organized Health Care Education/Training Program in Champaign, Illinois. Practices as a sole proprietor. Registered with an NPI since 2022.

In the registry since
2022
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Practice location Address checks out

807 S Wright St
Champaign, IL 61820-6233
Phone: (513) 728-1343
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Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1053069179
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMarch 17, 2022
Last updated in NPPESMarch 17, 2022
Certification dateMarch 17, 2022
Mailing address807 S Wright St, Champaign, IL 61820-6233

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