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

Timothy James Peterson, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1497259360

Timothy James Peterson, MD is a Family Practice in Chicago, Illinois. Graduated from University of Wisconsin School of Medicine in 2018, 8 years ago. Practices with The Board of Trustees of the University of Illinois, a 1,142-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
8
Trained at
University of Wisconsin School of Medicine
Licensed in
IL
In the registry since
2018
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

4630 S Bishop St
Chicago, IL 60609-3240
Phone: (312) 996-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1740 W Taylor St, Chicago, IL 60612-7232 — (866) 600-2273

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 036.156545 (IL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1497259360
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 23, 2018
Last updated in NPPESJuly 28, 2021
Certification dateJuly 28, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolUNIVERSITY OF WISCONSIN SCHOOL OF MEDICINE
Graduated 2018 (8 years in practice)
Group practice The Board Of Trustees Of The University Of Illinois — 1142 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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