Alwan Percell, Renee
Alwan Percell, Renee is an individual health care provider with primary practice located at 1701 E College Ave , Bloomington IL 61704-2101. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Alwan Percell, Renee can be contacted via phone (309) 664-3000.Contact Information
Primary practice address
1701 E College Ave
Bloomington IL 61704-2101
Phone: (309) 664-3000
Fax: (309) 664-3026
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 3289 | Arizona |
Profile Details
NPI number | 1588653935 |
---|---|
LBN Legal business name | Alwan Percell, Renee |
Credentials | Physician's Assistant Certified (PA-C) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Oct 18th, 2005 |
Last updated | Sep 20th, 2010 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1588653935 | NPPES |
Illinois | Other | IL2613 | MEDICARE GROUP NUMBER |
Illinois | Other | 031815 | MEDICARE GROUP NUMBER |
Illinois | Other | 031820 | MEDICARE GROUP NUMBER |
Illinois | Other | 3289 | MEDICARE GROUP NUMBER |
Illinois | Other | 031813 | MEDICARE GROUP NUMBER |
Illinois | Other | 031814 | MEDICARE GROUP NUMBER |
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