Dewar, James Daniel
Dewar, James Daniel is an sole proprietor health care provider with primary practice located at 530 Ne Glen Oak Ave , Peoria IL 61637-0001. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Interventional Cardiology is his primary health care specialty. Dewar, James Daniel can be contacted via phone (309) 655-7257.Contact Information
Primary practice address
530 Ne Glen Oak Ave
Peoria IL 61637-0001
Phone: (309) 655-7257
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 125-049248 | Illinois |
Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | 56304 | Minnesota |
Profile Details
NPI number | 1013128222 |
---|---|
LBN Legal business name | Dewar, James Daniel |
Credentials | Doctor of Osteopathy (DO) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | May 28th, 2007 |
Last updated | Aug 29th, 2013 - about 11 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 | 1013128222 | NPPES |
Illinois | MEDICAID | 036120002 | |
Illinois | Other | CA4079 | |
Illinois | Other | P00617111 | |
Illinois | Other | 809840 |
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