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
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053518092 NPPES
Illinois Other 036117194 STATE MEDICAL LICENSE

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