Gregory, David Carl

Gregory, David Carl is an individual health care provider with primary practice located at 2321 N Wisconsin Ave , Peoria IL 61603-5613. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Gregory, David Carl can be contacted via phone (309) 495-8644.

Contact Information

Primary practice address
2321 N Wisconsin Ave Peoria IL 61603-5613
Phone: (309) 495-8644
Fax: (309) 681-8443
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036103155 Illinois

Profile Details

NPI number 1871599522
LBN Legal business name Gregory, David Carl
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 27th, 2005
Last updated Sep 15th, 2023 - about last year

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 1871599522 NPPES
Illinois MEDICAID 036103155

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