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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 8 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275898116 NPPES
Illinois Other 036-138186 STATE LICENSE

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