IndividualActive
Jaclyn Petrov, APN
NPI 1295399178 · Obstetrics & Gynecology Nurse Practitioner · Mokena, IL
Provider details
- NPI number
- 1295399178
- Entity type
- Individual
- Primary specialty
- Obstetrics & Gynecology Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- APN
- Sex
- Female
- Sole proprietor
- No
- License
- 209.019158 (IN)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
10260 191st St Ste 100
Mokena, IL 60448-8802
Phone: (708) 572-7669
Fax: (708) 422-4253
Approximate (ZIP-level) locationGet directions
Mailing address
10260 191st St Ste 100
Mokena, IL 60448-8802
Additional practice locations (1)
- 9730 S Western AveEvergreen Park, IL 60805-2814Phone: (708) 425-1907Fax: (708) 422-4253
Registry dates
- Enumerated
- 2019-04-26
- Last updated
- 2022-09-28
- Certified
- 2022-09-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.