Heywood, Brian W

Heywood, Brian W is an individual health care provider with primary practice located at 900 Main St Suite 530, Peoria IL 61602-1005. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Heywood, Brian W can be contacted via phone (309) 672-5975.

Contact Information

Primary practice address
900 Main St Suite 530 Peoria IL 61602-1005
Phone: (309) 672-5975
Fax: (309) 655-1678
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 036081998 Illinois

Profile Details

NPI number 1669453114
LBN Legal business name Heywood, Brian W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 10th, 2005
Last updated Mar 30th, 2011 - about 14 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 1669453114 NPPES
Illinois MEDICAID 0360819982

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