MEDICARE: DR. NGUYET A LE-LINDQWISTER 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
1	207RH0003X	Hematology & Oncology Physician	036-106846	IL

General Provider Information

NPI Number	:	1174522486
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NGUYET A LE-LINDQWISTER MD

Provider Business Mailing Address
First Line	:	8940 N WOOD SAGE RD
Second Line	:
City	:	PEORIA
State	:	IL
Zip	:	61615-7822
Country	:	US
Telephone Number	:	309-243-3000
Fax Number	:

Provider Business Practice Location Address
First Line	:	8940 N WOOD SAGE RD
Second Line	:
City	:	PEORIA
State	:	IL
Zip	:	61615-7822
Country	:	US
Telephone Number	:	309-243-3000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	04/09/2019

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