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1215947171
LORI L PEGRAM
BLOOMINGTON, IL
NPI
1215947171
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207R00000X Internal Medicine
(Licence: IL 036072679)
Enumeration Date
2006-08-09
Last Update Date
2014-04-22
Business Address
-- LORI L PEGRAM MD
302 SAINT JOSEPH DR
BLOOMINGTON, IL 61701-3506
Phone number: 309-664-3100
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Mailing Address
-- LORI L PEGRAM MD
302 SAINT JOSEPH DR
BLOOMINGTON, IL 61701-3506
Phone number: 309-664-3100
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