Individual
PETRA KETTERL
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2330 PAYSPHERE CIR, CHICAGO, IL 60674-0023
(847) 746-4358
Mailing address
10109 E 79TH ST, TULSA, OK 74133-4564
(847) 746-4358
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
03/31/2006
Last updated
07/09/2007
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