Ly, Peter N.

Ly, Peter N. is an individual health care provider with primary practice located at 7717 N. Orange Prairie Road , Peoria IL 61615. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot Surgery, which is considered as his primary health care specialty. Ly, Peter N. can be contacted via phone (619) 518-1506.

Contact Information

Primary practice address
7717 N. Orange Prairie Road Peoria IL 61615
Phone: (619) 518-1506
Fax: (309) 589-6994
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot Surgery 213ES0131X E3804 California

Profile Details

NPI number 1447254396
LBN Legal business name Ly, Peter N.
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2005
Last updated Mar 27th, 2013 - about 13 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 1447254396 NPPES
California MEDICAID 000E38040

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