Tim Petersen
Tim Petersen is a Driver in Fairview, Illinois. Licensed in Illinois. Registered with an NPI since 2017.
- Licensed in
- IL
- In the registry since
- 2017
Practice location Address checks out
32059 N State Route 97Fairview, IL 61432-9643
Phone: (309) 414-2155
Show map & directions
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Driver (primary) | Taxonomy 172A00000X · Licence P362-8106-6065 (IL) |
|---|
Record details
| NPI number | 1689113680 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | February 23, 2017 |
| Last updated in NPPES | February 23, 2017 |
| Mailing address | 32059 N State Route 97, Fairview, IL 61432-9643 |