Active NPI
Girelle Peterson, PA-C
- Physician Assistant
- Orland Park, IL
National Provider Identifier
1629634449
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 085007005
- Practice address
- 60 Orland Square Dr Ste 101
Orland Park, IL 60462-6522 - Phone
- (708) 914-5145
- NPI assigned
- May 16, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 085007005 | IL | Primary |
Addresses
Primary practice location
60 Orland Square Dr Ste 101
Orland Park, IL 60462-6522
Mailing address
1293 Trinity Dr
Carol Stream, IL 60188-4354
Phone (630) 550-6144
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557964800000",
"number": "1629634449",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1293 TRINITY DR",
"city": "CAROL STREAM",
"state": "IL",
"postal_code": "601884354",
"telephone_number": "630-550-6144"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "60 ORLAND SQUARE DR STE 101",
"city": "ORLAND PARK",
"state": "IL",
"postal_code": "604626522",
"telephone_number": "708-914-5145"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "GIRELLE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-16",
"last_updated": "2019-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IL",
"license": "085007005",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orland Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.