Anderson, Donald R.

Anderson, Donald R. is an individual health care provider with primary practice located at 530 Ne Glen Oak Ave , Peoria IL 61637-5349. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Anderson, Donald R. can be contacted via phone (309) 655-2000.

Contact Information

Primary practice address
530 Ne Glen Oak Ave Peoria IL 61637-5349
Phone: (309) 655-2000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 01064057A Indiana
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 036-147236 Illinois

Profile Details

NPI number 1609090026
LBN Legal business name Anderson, Donald R.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 13th, 2007
Last updated Jan 3rd, 2024 - about 8 months 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609090026 NPPES
Indiana MEDICAID 200866860

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