Penn, Donald E

Penn, Donald E is an individual health care provider with primary practice located at 1001 Main St Suite 500A, Peoria IL 61606. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Penn, Donald E can be contacted via phone (309) 672-4980.

Contact Information

Primary practice address
1001 Main St Suite 500A Peoria IL 61606
Fax: (309) 671-2944
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X 036062844 Illinois

Profile Details

NPI number 1780628388
LBN Legal business name Penn, Donald E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 15th, 2006
Last updated May 29th, 2009 - about 16 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 1780628388 NPPES
Illinois Other 371221637 FEDERAL TAX IDENTIFICATIO
Illinois Other 07215152 FEDERAL TAX IDENTIFICATIO
Illinois Other 166330 FEDERAL TAX IDENTIFICATIO
Illinois Other 100004399 FEDERAL TAX IDENTIFICATIO
Illinois Other IL0101 FEDERAL TAX IDENTIFICATIO
Illinois Other 4282553 FEDERAL TAX IDENTIFICATIO
Illinois Other 008850 FEDERAL TAX IDENTIFICATIO
Illinois MEDICAID 036062844 FEDERAL TAX IDENTIFICATIO
Illinois Other 776530 FEDERAL TAX IDENTIFICATIO

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