Gentry, George

Gentry, George is an individual health care provider with primary practice located at 5409 N Knoxville Ave , Peoria IL 61615. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Gentry, George can be contacted via phone (309) 682-7750.

Contact Information

Primary practice address
5409 N Knoxville Ave Peoria IL 61615
Phone: (309) 682-7750
Fax: (309) 682-7786
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 036-080941 Illinois

Profile Details

NPI number 1225016975
LBN Legal business name Gentry, George
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 4th, 2006
Last updated Jul 2nd, 2024 - about 2 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 1225016975 NPPES
Illinois Other 300027879 RAILROAD MEDICARE
Illinois Other 054573 RAILROAD MEDICARE
Illinois Other 211015 RAILROAD MEDICARE
Illinois Other 0007222342 RAILROAD MEDICARE
Illinois MEDICAID 036080941-1 RAILROAD MEDICARE
Illinois Other 370947902 RAILROAD MEDICARE
Illinois Other 1005156 RAILROAD MEDICARE
Illinois Other IL0100 RAILROAD MEDICARE

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