Matthew McMillin, MD
Family Medicine in Peoria, IL. Individual provider (NPI-1).
NPI number1528021987
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1528021987
- Entity type
- Individual (NPI-1)
- Name
- Matthew McMillin
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 7, 2006
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 036098375 | IL | Yes |
Practice location
221 Ne Glen Oak AvePeoria, IL 61603-4307
Phone 309-672-5522
Mailing address
21276 Network PlChicago, IL 60673-1212
Phone 877-485-4474
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