Search › Illinois › 363LX0001X
Jaclyn Petrov, APN
NPI 1295399178 · on the registry since 2019
Practice
- Address
- 10260 191st St Ste 100
Mokena, IL 60448 - Phone
- (708) 572-7669
- Fax
- (708) 422-4253
- Organisation at this address
- A Lota Healthcare Ltd
Prime Medical Imaging, Llc
Providea Health Partners, LlcInferred from a shared address, not stated in the registry. - Clinicians at this address
- 9
Additional practice sites
- 9730 S Western Ave, Evergreen Park, IL
Registry record
- Primary taxonomy
- 363LX0001X
363LX0001X
- Licence states on file
- IN
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2022-09-28
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois