Bowman, Reginald

Bowman, Reginald is an individual health care provider with primary practice located at 600 S 13Th St Ste A, Pekin IL 61554-4936. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Bowman, Reginald can be contacted via phone (309) 347-2191.

Contact Information

Primary practice address
600 S 13Th St Ste A Pekin IL 61554-4936
Phone: (309) 347-2191
Fax: (309) 347-4821
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X R1562 Arizona
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 036127588 Illinois

Profile Details

NPI number 1316101892
LBN Legal business name Bowman, Reginald
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 15th, 2008
Last updated Jan 15th, 2013 - about 12 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1316101892 NPPES
Illinois MEDICAID 036127588

Popular Providers