Pearl, Richard

Pearl, Richard is an individual health care provider with primary practice located at 420 Ne Glen Oak Ave Ste 201, Peoria IL 61603-3105. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Surgery, which is considered as his primary health care specialty. Pearl, Richard can be contacted via phone (309) 655-3800.

Contact Information

Primary practice address
420 Ne Glen Oak Ave Ste 201 Peoria IL 61603-3105
Phone: (309) 655-3800
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Surgery 2086S0120X 036098051 Illinois

Profile Details

NPI number 1457389272
LBN Legal business name Pearl, Richard
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 29th, 2006
Last updated Jul 8th, 2007 - about 18 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 1457389272 NPPES
Illinois Other 7215166 BCBS
Illinois MEDICAID 036098051-2 BCBS

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