Reginald Bowman, | |
600 S 13th St, Ste A, Pekin, IL 61554-4936 | |
(309) 347-2191 | |
(309) 347-4821 |
Full Name | Reginald Bowman |
---|---|
Gender | Male |
Speciality | Pediatrics |
Location | 600 S 13th St, Pekin, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1316101892 | NPI | - | NPPES |
036127588 | Medicaid | IL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | R1562 (Arizona) | Secondary |
208000000X | Pediatrics | 036127588 (Illinois) | Primary |
Entity Name | Methodist Medical Center Of Illinois |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1982656575 PECOS PAC ID: 1355259714 Enrollment ID: O20031126000494 |
Entity Name | Proctor Health Systems |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1134173917 PECOS PAC ID: 3476440173 Enrollment ID: O20040227000906 |
Mailing Address | Practice Location Address |
---|---|
Reginald Bowman, 600 S 13th St, Ste A, Pekin, IL 61554-4936 Ph: (309) 347-2191 | Reginald Bowman, 600 S 13th St, Ste A, Pekin, IL 61554-4936 Ph: (309) 347-2191 |
Ann Parkin-cohen, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 3422 Court St, Pekin, IL 61554 Phone: 309-680-7600 Fax: 309-495-6698 | |
Dr. Ashley Fischer, M.D, Pediatrics Medicare: Medicare Enrolled Practice Location: 3223 Griffin Ave, Pekin, IL 61554 Phone: 309-353-1822 | |
Dr. Mohammed Ali Khan, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 3212 Court St, Pekin, IL 61554 Phone: 309-306-1234 Fax: 309-213-9661 |