Rufus Jr, Edward A

Rufus Jr, Edward A is an sole proprietor health care provider with primary practice located at 5401 N Knoxville Ave Suite 306, Peoria IL 61614-5098. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Rufus Jr, Edward A can be contacted via phone (309) 691-7890.

Contact Information

Primary practice address
5401 N Knoxville Ave Suite 306 Peoria IL 61614-5098
Phone: (309) 691-7890
Fax: (309) 691-7898
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 036073126 Illinois

Profile Details

NPI number 1871597450
LBN Legal business name Rufus Jr, Edward A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 10th, 2005
Last updated Oct 14th, 2009 - about 15 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 1871597450 NPPES
Illinois MEDICAID 036073126
Illinois Other 7200599

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