Healthcare Provider Details

I. General information

NPI: 1689831349
Provider Name (Legal Business Name): CHERYL ANNE PETSCHKE DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2008
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7627 LAKE STREET SUITE 206 PMB 1102
RIVER FOREST IL
60305
US

IV. Provider business mailing address

7627 LAKE STREET SUITE 206 PMB 1102
RIVER FOREST IL
60305
US

V. Phone/Fax

Practice location:
  • Phone: 815-341-8489
  • Fax:
Mailing address:
  • Phone: 815-341-8489
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038.011151
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: