Provider Demographics
NPI:1689831349
Name:PETSCHKE, CHERYL ANNE (DC)
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:ANNE
Last Name:PETSCHKE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:158 BARTLETT PLZ
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:IL
Mailing Address - Zip Code:60103-4234
Mailing Address - Country:US
Mailing Address - Phone:630-830-2121
Mailing Address - Fax:630-830-2195
Practice Address - Street 1:158 BARTLETT PLZ
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:IL
Practice Address - Zip Code:60103-4234
Practice Address - Country:US
Practice Address - Phone:630-830-2121
Practice Address - Fax:630-830-2195
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-20
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.011151111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor