West, Terry Dale
West, Terry Dale is an sole proprietor health care provider with primary practice located at 302 Randall Rd Suite 205, Geneva IL 60134-4204. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. West, Terry Dale can be contacted via phone (630) 232-4224.Contact Information
Primary practice address
302 Randall Rd Suite 205
Geneva IL 60134-4204
Phone: (630) 232-4224
Fax: (630) 232-0150
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 36059820 | Illinois |
Profile Details
| NPI number | 1629034319 |
|---|---|
| LBN Legal business name | West, Terry Dale |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 22nd, 2006 |
| Last updated | Dec 14th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629034319 | NPPES |
| Illinois | Other | 04500701 | BLUE CROSS |
| Illinois | MEDICAID | 036059820 | BLUE CROSS |
| Illinois | Other | 4095282 | BLUE CROSS |
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