Deguzman, Samuel G
Deguzman, Samuel G is an sole proprietor health care provider with primary practice located at 450 Kennedy Drive Suite 5, Kankakee IL 60901. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Deguzman, Samuel G can be contacted via phone (815) 937-5900.Contact Information
Primary practice address
450 Kennedy Drive Suite 5
Kankakee IL 60901
Phone: (815) 937-5900
Fax: (815) 937-1748
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 036047840 | Illinois |
Profile Details
| NPI number | 1235103532 |
|---|---|
| LBN Legal business name | Deguzman, Samuel G |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 14th, 2006 |
| Last updated | Dec 9th, 2009 - about 15 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 | 1235103532 | NPPES |
| Illinois | MEDICAID | 036047840 |
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