Chilson, Dale R
Chilson, Dale R is an individual health care provider with primary practice located at 4040 Progress Blvd , Peru IL 61354-1124. He recently has only one registered license in Allopathic & Osteopathic Physicians / Facial Plastic Surgery, which is considered as his primary health care specialty. Chilson, Dale R can be contacted via phone (815) 224-3040.Contact Information
Primary practice address
4040 Progress Blvd
Peru IL 61354-1124
Phone: (815) 224-3040
Fax: (815) 224-4327
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Facial Plastic Surgery | 207YS0123X | 036096113 | Illinois |
Profile Details
| NPI number | 1235141664 |
|---|---|
| LBN Legal business name | Chilson, Dale R |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 13th, 2006 |
| Last updated | Aug 25th, 2008 - about 17 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 | 1235141664 | NPPES |
| Illinois | MEDICAID | 036096113 |
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