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NPI Code Detail

MEDICARE: DR. DONALD HABECKER MD

MEDICARE: DR. DONALD HABECKER MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianIL

General Provider Information

NPI Number : 1851482731
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DONALD HABECKER MD
Provider Business Mailing Address
First Line : 1120 E WAR MEMORIAL DR
Second Line :
City : PEORIA HEIGHTS
State : IL
Zip : 61616-7757
Country : US
Telephone Number : 309-685-0100
Fax Number : 309-685-0172
Provider Business Practice Location Address
First Line : 1120 E WAR MEMORIAL DR
Second Line :
City : PEORIA HEIGHTS
State : IL
Zip : 61616-7757
Country : US
Telephone Number : 309-685-0100
Fax Number : 309-685-0172
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2006
Last Update Date : 07/09/2007

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Directions to “ DR. DONALD HABECKER MD” Practice Location

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