CHANNING PETRAK

PEORIA, IL
NPI1952370538
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy208000000X Pediatrics
(Licence: IL  036108511)
Enumeration Date2006-03-16
Last Update Date2013-07-22
Business Address
-- CHANNING PETRAK MD
DEPT OF PEDIATRICS 320 E ARMSTRONG
PEORIA, IL 61603
Phone number: 309-624-9587
Mailing Address
-- CHANNING PETRAK MD
1 ILLINI DR
PEORIA, IL 61605-2576
Phone number: 309-671-8503
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