Med Contract Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036103715 Issued in IL

Legal business name

MED CONTRACT INC

Doing business as

Dr. Patrick E. Peterson

Practice address

911 4TH St
Eldorado, IL 62930-1203

Phone

(618) 273-2100

Fax

(618) 273-2110

NPI assigned

Mar 8, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Patrick Edward Peterson, D.O.

Title

Healthcare Provider

Phone

(618) 273-2100

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Patrick E. Peterson Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221177600000",
    "number": "1679540686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 BLUE EARTH LN",
            "city": "HARRISBURG",
            "state": "IL",
            "postal_code": "629464576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 4TH ST",
            "city": "ELDORADO",
            "state": "IL",
            "postal_code": "629301203",
            "telephone_number": "618-273-2100",
            "fax_number": "618-273-2110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED CONTRACT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-08",
        "last_updated": "2008-09-12",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "HEALTHCARE PROVIDER",
        "authorized_official_telephone_number": "618-273-2100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036103715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0361037154",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Patrick E. Peterson",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Medicine Physician in Eldorado, IL
• Providers in Eldorado, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.