MEDICARE: DR. PEDRO A DE ALARCON 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	2080P0207X	Pediatric Hematology & Oncology Physician	38265	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841293032
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PEDRO A DE ALARCON MD

Provider Business Mailing Address
First Line	:	CHILDREN'S HOSPITAL OF IL 530 NE GLEN OAK AVE
Second Line	:
City	:	PEORIA
State	:	IL
Zip	:	61637-0001
Country	:	US
Telephone Number	:	309-655-4242
Fax Number	:	309-655-2565

Provider Business Practice Location Address
First Line	:	CHILDREN'S HOSPITAL OF ILLINOIS 530 NE GLEN OAK AVE
Second Line	:
City	:	PEORIA
State	:	IL
Zip	:	61637
Country	:	US
Telephone Number	:	309-655-4242
Fax Number	:	309-655-2565

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

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	08/29/2018

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Directions to “ DR. PEDRO A DE ALARCON MD” Practice Location

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