Correa, Candace

Correa, Candace is an individual health care provider with primary practice located at 221 Ne Glen Oak Ave , Peoria IL 61636-3813. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Radiation Oncology, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Radiation Oncology is her primary health care specialty. Correa, Candace can be contacted via phone (093) 672-5700.

Contact Information

Primary practice address
221 Ne Glen Oak Ave Peoria IL 61636-3813
Phone: (093) 672-5700
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Radiation Oncology 2085R0001X 4301085775 Michigan
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X 4301085775 Michigan
Allopathic & Osteopathic Physicians / Radiation Oncology 2085R0001X 262688 New York

Profile Details

NPI number 1952420671
LBN Legal business name Correa, Candace
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 28th, 2007
Last updated Apr 25th, 2019 - about 7 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 1952420671 NPPES
New York Other P01365713 RRMCR
New York MEDICAID 03808642 RRMCR

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