Provider Demographics
NPI:1083337141
Name:BARKER, PATRECE ANTOINETTE (DO, MS)
Entity type:Individual
Prefix:
First Name:PATRECE
Middle Name:ANTOINETTE
Last Name:BARKER
Suffix:
Gender:F
Credentials:DO, MS
Other - Prefix:
Other - First Name:PATRECE
Other - Middle Name:ANOTINETTE
Other - Last Name:BRANCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2401 W ALTA RD APT 3207
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61615-4613
Mailing Address - Country:US
Mailing Address - Phone:806-382-8327
Mailing Address - Fax:
Practice Address - Street 1:815 MAIN ST STE C
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61602-1080
Practice Address - Country:US
Practice Address - Phone:309-672-4986
Practice Address - Fax:309-672-4790
Is Sole Proprietor?:No
Enumeration Date:2022-09-23
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.084423207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine