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:
Health care specialties
Specialty | Code | License # | 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 6 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 | 1952420671 | NPPES |
New York | Other | P01365713 | RRMCR |
New York | MEDICAID | 03808642 | RRMCR |
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