Chenoweth, Daryl

Chenoweth, Daryl is an individual health care provider with primary practice located at 7309 N Knoxville Ave , Peoria IL 61614-2085. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Chenoweth, Daryl can be contacted via phone (309) 282-0827.

Contact Information

Primary practice address
7309 N Knoxville Ave Peoria IL 61614-2085
Phone: (309) 282-0827
Fax: (309) 683-1003
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 209001108 Illinois

Profile Details

NPI number 1902871312
LBN Legal business name Chenoweth, Daryl
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 20th, 2006
Last updated Feb 24th, 2015 - about 11 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 1902871312 NPPES
Illinois Other 5707858 BCBS PROVIDER NUMBER

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