Individual
ARTHUR S PETTIGREW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
396 REMINGTON BLVD STE 380, BOLINGBROOK, IL 60440-4302
(224) 273-4000
Mailing address
396 REMINGTON BLVD STE 380, BOLINGBROOK, IL 60440-4302
(224) 273-4000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036101644
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036101644
—
IL
01
—
080158547
RAILROAD MEDICARE PTAN
IL
01
—
399980
MEDICARE GROUP PTAN
IL
Enumeration date
01/09/2007
Last updated
03/25/2021
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