Polo, Therese L
Polo, Therese L is an sole proprietor health care provider with primary practice located at 807 Broadway St , Gillespie IL 62033-1100. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Polo, Therese L can be contacted via phone (217) 839-3900.Contact Information
Primary practice address
807 Broadway St
Gillespie IL 62033-1100
Phone: (217) 839-3900
Fax: (217) 839-1313
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | Illinois |
Profile Details
| NPI number | 1215088000 |
|---|---|
| LBN Legal business name | Polo, Therese L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 16th, 2007 |
| Last updated | Jul 8th, 2007 - about 19 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215088000 | NPPES |
| Other | 427533 | HEALTHLINK | |
| Other | 0005932020 | HEALTHLINK |
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