Petrie, Patricia
Petrie, Patricia is an sole proprietor health care provider with primary practice located at 315 S Peoria Ave , Dixon IL 61021-2956. She recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as her primary health care specialty. Petrie, Patricia can be contacted via phone (815) 288-3614.Contact Information
Primary practice address
315 S Peoria Ave
Dixon IL 61021-2956
Phone: (815) 288-3614
Fax: (815) 285-3525
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | 038-004367 | Illinois |
Profile Details
| NPI number | 1255336764 |
|---|---|
| LBN Legal business name | Petrie, Patricia |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 21st, 2005 |
| Last updated | Jan 10th, 2013 - about 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1255336764 | NPPES |
| Illinois | MEDICAID | 038004367 | |
| Illinois | Other | 350047766 | |
| Illinois | Other | 05282006 |
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