Petrov, Anna M

Petrov, Anna M is an individual health care provider with primary practice located at 4108 N Sheridan Rd , Chicago IL 60613-2007. She recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Podiatric Medicine & Surgery Service Providers / Foot Surgery. Podiatric Medicine & Surgery Service Providers / Foot Surgery is her primary health care specialty. Petrov, Anna M can be contacted via phone (773) 244-6517.

Contact Information

Primary practice address
4108 N Sheridan Rd Chicago IL 60613-2007
Phone: (773) 244-6517
Fax: (773) 244-6531
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 016004935 Illinois
Podiatric Medicine & Surgery Service Providers / Foot Surgery 213ES0131X 016004935 Illinois

Profile Details

NPI number 1407837040
LBN Legal business name Petrov, Anna M
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 10th, 2005
Last updated May 13th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407837040 NPPES
Other 1626058 BC/BS
MEDICAID 016004935 BC/BS

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