Costerisan, Dennis D

Costerisan, Dennis D is an sole proprietor health care provider with primary practice located at 320 E Central Ave , Decatur IL 62521-4665. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Costerisan, Dennis D can be contacted via phone (217) 877-9117.

Contact Information

Primary practice address
320 E Central Ave Decatur IL 62521-4665
Phone: (217) 877-9117
Fax: (217) 877-3078
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036071025 Illinois

Profile Details

NPI number 1578565701
LBN Legal business name Costerisan, Dennis D
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 1st, 2005
Last updated Jan 25th, 2022 - about 2 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1578565701 NPPES
Illinois Other 080105720 RAILROAD MEDICARE
Illinois Other 178026 RAILROAD MEDICARE
Illinois MEDICAID 0360710252 RAILROAD MEDICARE
Illinois Other 0007005197 RAILROAD MEDICARE

Popular Providers