Peru Primary Care Professionals Llc

LBN: Peru Primary Care Professionals Llc
Peru Primary Care Professionals Llc is an health care organization with primary practice located at 920 West St Suite 311, Peru IL 61354-2763. The organization recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Geriatric Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty. Peru Primary Care Professionals Llc can be contacted via phone (815) 223-9214, or through Fernandez, Mark A. via phone (815) 223-9214.

Contact Information

Primary practice address
920 West St Suite 311 Peru IL 61354-2763
Phone: (815) 223-9214
Fax: (815) 223-9322
Website:
Map and Directions
Authorized official contact:
Name: Fernandez, Mark A. Doctor of Medicine (MD)
Phone: (815) 223-9214

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036111100 Illinois
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 036089936 Illinois
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X 036089936 Illinois
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 036089936 Illinois

Profile Details

NPI number 1568591048
LBN Legal business name Peru Primary Care Professionals Llc
DBA Doing business as
Authorized official Fernandez, Mark A. Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 2nd, 2007
Last updated Nov 20th, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568591048 NPPES
Illinois MEDICAID 036111100
Illinois MEDICAID 036089936

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