Archer, Derek C
Archer, Derek C is an sole proprietor health care provider with primary practice located at 22N285 Pepper Rd Suite #103, Lake Barrington IL 60010-5982. He recently has only one registered license in Allopathic & Osteopathic Physicians / Body Imaging, which is considered as his primary health care specialty. Archer, Derek C can be contacted via phone (847) 732-2739.Contact Information
Primary practice address
22N285 Pepper Rd Suite #103
Lake Barrington IL 60010-5982
Phone: (847) 732-2739
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Body Imaging | 2085B0100X | 36084401 | Illinois |
Profile Details
| NPI number | 1629164256 |
|---|---|
| LBN Legal business name | Archer, Derek C |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 4th, 2006 |
| Last updated | Sep 18th, 2008 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629164256 | NPPES |
| Illinois | MEDICAID | 036-084401#1 |
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