Dina, Pele Boutrous
Dina, Pele Boutrous is an individual health care provider with primary practice located at 415 N 9Th St # 4W16 , Springfield IL 62702. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine, which is considered as his primary health care specialty. Dina, Pele Boutrous can be contacted via phone (217) 545-8000.Contact Information
Primary practice address
415 N 9Th St # 4W16
Springfield IL 62702
Phone: (217) 545-8000
Fax: (217) 757-6844
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine | 2080N0001X | 036-138186 | Illinois |
Profile Details
| NPI number | 1275898116 |
|---|---|
| LBN Legal business name | Dina, Pele Boutrous |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 6th, 2012 |
| Last updated | May 16th, 2018 - 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 | 1275898116 | NPPES |
| Illinois | Other | 036-138186 | STATE LICENSE |
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