Individual
DR. MATTHEW ALLEN PETRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
12624 S ROUTE 59 UNIT 2, PLAINFIELD, IL 60585-5448
(815) 254-1234
(815) 254-2020
Mailing address
12624 S ROUTE 59 UNIT 2, PLAINFIELD, IL 60585-5448
(815) 254-1234
(815) 254-2020
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038-009285
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2232398
BCBS PPO
IL
Enumeration date
03/30/2007
Last updated
12/20/2013
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