IndividualActive
Bruce Peterson, MD
NPI 1821108010 · Pediatrics Physician · Roscoe, IL
Provider details
- NPI number
- 1821108010
- Entity type
- Individual
- Primary specialty
- Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- 036-053478 (IL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
5000 Prairie Rose Dr
Roscoe, IL 61073-7792
Phone: (815) 971-2000
Approximate (ZIP-level) locationGet directions
Mailing address
5000 Prairie Rose Dr
Roscoe, IL 61073-7792
Registry dates
- Enumerated
- 2006-08-30
- Last updated
- 2010-01-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.