Most Relevant Information
Provider Data
| NPI Number: | 1003547977 |
| Provider Name: | JONATHAN DAVID PETERS MA, LPCC, LADC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: | 304604 |
Most Important Dates
| Enumeration Date: | 06/22/2022 |
| Last Updated: | 07/10/2024 |
Provider Practice Location
867 N DEARBORN ST
CHICAGO
IL
606103310
Practice Location Phone/Fax
| Phone: | 8002577800 |
| Fax: | 3129433530 |
Provider Mailing Location
5534 N KENMORE AVE APT 309
CHICAGO
IL
606401544
Provider Mailing Phone/Fax
| Phone: | 6128108128 |
| Fax: |