Corley, Richard D
Corley, Richard D is an individual health care provider with primary practice located at 808 W Trailcreek Dr , Peoria IL 61614-1862. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic Surgery, which is considered as his primary health care specialty. Corley, Richard D can be contacted via phone (309) 693-3122.Contact Information
Primary practice address
808 W Trailcreek Dr
Peoria IL 61614-1862
Phone: (309) 693-3122
Fax: (309) 693-4250
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Plastic Surgery | 208200000X | 036 037 295 | Illinois |
Profile Details
| NPI number | 1801914882 |
|---|---|
| LBN Legal business name | Corley, Richard D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 27th, 2007 |
| Last updated | Jul 9th, 2014 - about 10 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 | 1801914882 | NPPES |
| Illinois | MEDICAID | 036037295 |
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