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1740211002
RICHARD C FREDERICK
PEORIA, IL
NPI
1740211002
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207P00000X Emergency Medicine
(Licence: IL 036-057586)
Enumeration Date
2006-07-05
Last Update Date
2007-07-09
Business Address
-- RICHARD C FREDERICK M.D.
530 NE GLEN OAK AVE
PEORIA, IL 61637-0001
Phone number: 309-655-2553
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Mailing Address
-- RICHARD C FREDERICK M.D.
530 NE GLEN OAK AVE
PEORIA, IL 61637-0001
Phone number: 309-655-2000
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