Healthcare Provider Details

I. General information

NPI: 1801849419
Provider Name (Legal Business Name): PAGE V SETTLES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 03/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 OLT AVE
PEKIN IL
61554-6216
US

IV. Provider business mailing address

19 OLT AVE
PEKIN IL
61554-6216
US

V. Phone/Fax

Practice location:
  • Phone: 309-353-6301
  • Fax: 309-353-1555
Mailing address:
  • Phone: 309-353-6301
  • Fax: 309-353-1555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: