Wise, Neil Kent
Wise, Neil Kent is an individual health care provider with primary practice located at 5405 N Knoxville Ave , Peoria IL 61614. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Wise, Neil Kent can be contacted via phone (309) 691-4410.Contact Information
Primary practice address
5405 N Knoxville Ave
Peoria IL 61614
Phone: (309) 691-4410
Fax: (309) 589-2830
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 036050195 | Illinois |
Profile Details
| NPI number | 1164456463 |
|---|---|
| LBN Legal business name | Wise, Neil Kent |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 10th, 2006 |
| Last updated | Sep 1st, 2010 - about 14 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 | 1164456463 | NPPES |
| Illinois | MEDICAID | 036050195 |
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