Raso, Michael M
Raso, Michael M is an individual health care provider with primary practice located at 1115 N Bourland Ave , Peoria IL 61606-1210. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Raso, Michael M can be contacted via phone (309) 264-0730.Contact Information
Primary practice address
1115 N Bourland Ave
Peoria IL 61606-1210
Phone: (309) 264-0730
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 036117194 | Illinois |
Profile Details
| NPI number | 1053518092 |
|---|---|
| LBN Legal business name | Raso, Michael M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 2nd, 2007 |
| 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 | 1053518092 | NPPES |
| Illinois | Other | 036117194 | STATE MEDICAL LICENSE |
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