| Peru Primary Care Professionals Llc | |
|
920 West St Suite 311 Peru IL 61354-2763 | |
| (815) 223-9214 | |
| (815) 223-9322 |
| Full Name | Peru Primary Care Professionals Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 920 West St, Peru, Illinois |
| Authorized Official Name and Position | Mark A. Fernandez (PARTNER) |
| Authorized Official Contact | 8152239214 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Peru Primary Care Professionals Llc 920 West St Suite 311 Peru IL 61354-2763 Ph: (815) 223-9214 | Peru Primary Care Professionals Llc 920 West St Suite 311 Peru IL 61354-2763 Ph: (815) 223-9214 |
| NPI Number | 1568591048 |
|---|---|
| Provider Enumeration Date | 03/02/2007 |
| Last Update Date | 11/20/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568591048 | NPI | - | NPPES |
| 036111100 | Medicaid | IL | |
| 036089936 | Medicaid | IL |
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