Petrak, Richard A

Petrak, Richard A is an sole proprietor health care provider with primary practice located at 3231 Euclid Ave Suite 405, Berwyn IL 60402-3471. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Pulmonary Disease is his primary health care specialty. Petrak, Richard A can be contacted via phone (708) 783-2644.

Contact Information

Primary practice address
3231 Euclid Ave Suite 405 Berwyn IL 60402-3471
Phone: (708) 783-2644
Fax: (708) 783-3973
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X 036072033 Illinois
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X 036072033 Illinois

Profile Details

NPI number 1891708608
LBN Legal business name Petrak, Richard A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 14th, 2006
Last updated Mar 1st, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891708608 NPPES
Illinois MEDICAID 036072033
Illinois Other 36072033
Illinois Other P00062672

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