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General NPI Number Information
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NPI Number | 1841293032
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Entity Type | Individual
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Provider Name | PEDRO A DE ALARCON MD
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Gender | Male
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Dates
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Enumeration Date | 05/23/2005
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Last Update Date | 08/29/2018
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Provider Practice Location Address
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Address Line | CHILDREN'S HOSPITAL OF ILLINOIS 530 NE GLEN OAK AVE
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City | PEORIA
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State | IL
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Zip | 61637
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Country | US
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Telephone | 309-655-4242
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Fax | 309-655-2565
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Provider Business Mailing Address
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Address Line | CHILDREN'S HOSPITAL OF IL 530 NE GLEN OAK AVE
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City | PEORIA
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State | IL
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Zip | 61637-0001
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Country | US
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Telephone | 309-655-4242
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Fax | 309-655-2565
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0207X
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Taxonomy Name | Pediatric Hematology & Oncology Physician
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License Number | 38265
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License Number State | TN
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