Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Nicholas Ryan Petre, MD

Individual provider Family Medicine Physician · NPI 1699269308

Dr. Nicholas Ryan Petre, MD is a Family Practice in East Moline, Illinois. Graduated from Southern Illinois University School of Medicine in 2018, 8 years ago. Practices with Stone Ridge Medical Group SC, a 7-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
8
Trained at
Southern Illinois University School of Medicine
Licensed in
IL
In the registry since
2018
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

306 46th Ave
East Moline, IL 61244-4281
Phone: (309) 796-2329
Fax: (309) 796-1146
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 125.072248 (IL)

Record details

NPI number1699269308
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 15, 2018
Last updated in NPPESDecember 22, 2025
Certification dateDecember 22, 2025
Mailing address306 46th Ave, East Moline, IL 61244-4281

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolSOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE
Graduated 2018 (8 years in practice)
Group practice Stone Ridge Medical Group Sc — 7 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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