MEDICARE: ERIN M PETRIK DDS PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry

General Provider Information

NPI Number	:	1598605982
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ERIN M PETRIK DDS PLLC

Provider Business Mailing Address
First Line	:	2423 W FULLERTON AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60647-2484
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2423 W FULLERTON AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60647-2484
Country	:	US
Telephone Number	:	612-290-1434
Fax Number	:

Authorized Official
Title or Position	:	OWNER, MANAGING MEMBER
Name	:	DR. ERIN PETRIK
Credential	:	DDS
Telephone Number	:	612-290-1434

Provider Enumeration Date	:	03/30/2026
Last Update Date	:	03/30/2026

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