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Individual

ANNE M PETRE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
306 46TH AVE, EAST MOLINE, IL 61244-4281
(309) 796-2329
(309) 796-1146
Mailing address
306 46TH AVE, EAST MOLINE, IL 61244-4281
(309) 796-2329
(309) 796-1146

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
036-091695
IL
207Q00000X
Family Medicine Physician
Primary
036091695
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
020355
HEALTH ALLIANCE
05
036091695
IL
01
20083
IOWA HEALTH SOLUTIONS
01
4796890020
DMERC
01
90800
WELLMARK BC/BS
01
IL01F1
JOHN DEERE
Enumeration date
06/23/2005
Last updated
09/04/2015
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