Unknown Individual – Internal Medicine Physician, NPI 1225090434
Internal Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
1305, 6th Street, Peru, LaSalle County, Illinois, 61354, United States
PERU, IL 613542759
Phone: (815) 673-1565
Fax: (815) 673-5539
Type: Mailing
104, East Bridge Street, South Streator, Streator, LaSalle County, Illinois, 61364, United States
STREATOR, IL 613642976
Phone: (815) 673-1565
Fax: (815) 673-5539
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 61354)
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