Petrowich, Destiny Grace

Petrowich, Destiny Grace is an individual health care provider with primary practice located at 1603 W Kimmel St , Marion IL 62959-1008. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Petrowich, Destiny Grace can be contacted via phone (618) 993-2906.

Contact Information

Primary practice address
1603 W Kimmel St Marion IL 62959-1008
Phone: (618) 993-2906
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 085.007902 Illinois

Profile Details

NPI number 1063037711
LBN Legal business name Petrowich, Destiny Grace
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2020
Last updated Sep 24th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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