Channing Petrak, MD

NPI #1952370538 in Peoria, Illinois

Provider Information

NPI Number: 1952370538
Entity Type: Individual
Name: Channing Petrak, MD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pediatrics
Credential: MD
Enumeration Date: Mar 16, 2006
Last Updated: Jul 22, 2013

Practice Location

Address: DEPT OF PEDIATRICS
Address 2: 320 E ARMSTRONG
City: Peoria
State: Illinois
ZIP Code: 61603
Phone: (309) 624-9587

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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