Boerckel, Alexander James

Boerckel, Alexander James is an individual health care provider with primary practice located at 4517 N Rockwood Dr , Peoria IL 61615-3841. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Boerckel, Alexander James can be contacted via phone (309) 688-0121.

Contact Information

Primary practice address
4517 N Rockwood Dr Peoria IL 61615-3841
Phone: (309) 688-0121
Fax: (309) 688-5643
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 019.030868 Illinois

Profile Details

NPI number 1538613880
LBN Legal business name Boerckel, Alexander James
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 3rd, 2016
Last updated Dec 10th, 2020 - about 6 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538613880 NPPES
Illinois Other 1851909345 PEORIA DENTAL CARE, LLC

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