Healthcare Provider Details

I. General information

NPI: 1427323864
Provider Name (Legal Business Name): FRANCESCO VETRI M.D. PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2012
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 W HAY ST STE 213
DECATUR IL
62526-4169
US

IV. Provider business mailing address

5198 RELIABLE PKWY
CHICAGO IL
60686-0051
US

V. Phone/Fax

Practice location:
  • Phone: 217-876-6640
  • Fax: 217-876-6645
Mailing address:
  • Phone: 309-662-4321
  • Fax: 309-662-4532

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number036139414
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number036139414
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number036139414
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: