Macwan, Kamlesh Samson
Macwan, Kamlesh Samson is an individual health care provider with primary practice located at 530 Ne Glen Oak Ave St Francis Medical Center, Peoria IL 61637. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Macwan, Kamlesh Samson can be contacted via phone (309) 655-2485.Contact Information
Primary practice address
530 Ne Glen Oak Ave St Francis Medical Center
Peoria IL 61637
Phone: (309) 655-2485
Fax: (309) 655-2874
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 53948 | Illinois |
| Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine | 2080N0001X | 3248 | Illinois |
Profile Details
| NPI number | 1851306575 |
|---|---|
| LBN Legal business name | Macwan, Kamlesh Samson |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 30th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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 | 1851306575 | NPPES |
| Illinois | Other | 004082 | HEALTH ALLIANCE |
| Illinois | Other | IL0105 | HEALTH ALLIANCE |
| Illinois | MEDICAID | 03608163702 | HEALTH ALLIANCE |
| Illinois | Other | 7215111 | HEALTH ALLIANCE |
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