Search › Illinois › 101YM0800X
Ashanti Pettaway
NPI 1710729033 · on the registry since 2024
Practice
- Address
- 1147 W Ohio St
Chicago, IL 60642 - Phone
- (312) 772-9796
- Fax
- (312) 561-6974
- Organisation at this address
- Optimum Joy, P.C.
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 29
Registry record
- Primary taxonomy
- 101YM0800X
101YM0800X
- Sex
- Male
- Record last updated
- 2024-06-07
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