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Organization

ANNA PETROV DPM SC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANNA PETROV DPM (PRESIDENT)
(773) 244-6517
Entity
Organization

Contact information

Practice address
4108 N SHERIDAN RD, CHICAGO, IL 60613-2007
(773) 244-6517
(773) 244-6531
Mailing address
4108 N SHERIDAN RD, CHICAGO, IL 60613-2007
(773) 244-6517
(773) 244-6531

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1626058
BCBS
IL
Enumeration date
07/25/2006
Last updated
05/13/2013
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