Katherine Petersen, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085-009537 Issued in IL

Practice address

1 E Erie St Ste 530
Chicago, IL 60611-2792

Phone

(773) 677-4300

Fax

(773) 423-8429

NPI assigned

Oct 27, 2022

Last updated

Jul 8, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/ez_00174

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dupage Medical Group LTD

  dba DuPage Medical Group

  • Multi-Specialty Clinic/Center
  • Downers Grove, IL
  • NPI 1801833983
  Medicare reassignment NPD
• Kaminska Dermatology PLLC

  • Dermatology Physician
  • Chicago, IL
  • NPI 1265073415
  Medicare reassignment
• Dupage Medical Group LTD

  • Durable Medical Equipment & Medical Supplies
  • Glen Ellyn, IL
  • NPI 1760979447
  NPD
• Kaminska Dermatology

  • Dermatology Physician
  • Chicago, IL
  • NPI 1093377731
  NPD (past)

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

{
    "created_epoch": "1666828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1720705957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771260",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 E ERIE ST STE 530",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112792",
            "telephone_number": "773-677-4300",
            "fax_number": "773-423-8429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "KATHERINE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-27",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-009537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Peters, RPH
• Anna Petersen, MD
• Brooke Noel Petersen, LPC
• Elizabeth Petersen
• Erin Kathleen Petersen, MD
• Madison Nicole Petersen, PA-C
• Robyn Petersen
• Sierra Petersen, LCSW
• Valerie L Petersen, WHNP-BC
• Lauren Petersil

• Physician Assistant in Chicago, IL
• Providers in Chicago, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.