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1952370538
CHANNING PETRAK
PEORIA, IL
NPI
1952370538
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
208000000X Pediatrics
(Licence: IL 036108511)
Enumeration Date
2006-03-16
Last Update Date
2013-07-22
Business Address
-- CHANNING PETRAK MD
DEPT OF PEDIATRICS 320 E ARMSTRONG
PEORIA, IL 61603
Phone number: 309-624-9587
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Mailing Address
-- CHANNING PETRAK MD
1 ILLINI DR
PEORIA, IL 61605-2576
Phone number: 309-671-8503
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