Champagne, Ronald

Champagne, Ronald is an individual health care provider with primary practice located at 210 W Walnut St , Canton IL 61520-2444. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as his primary health care specialty. Champagne, Ronald can be contacted via phone (309) 647-5240.

Contact Information

Primary practice address
210 W Walnut St Canton IL 61520-2444
Phone: (309) 647-5240
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 036100240 Illinois

Profile Details

NPI number 1306884622
LBN Legal business name Champagne, Ronald
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 2nd, 2006
Last updated Aug 13th, 2012 - about 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306884622 NPPES
Illinois Other P00005646 RAILROAD MEDICARE
Illinois MEDICAID 0361002402 RAILROAD MEDICARE

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