Rufus Jr, Edward A
Rufus Jr, Edward A is an sole proprietor health care provider with primary practice located at 5401 N Knoxville Ave Suite 306, Peoria IL 61614-5098. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Rufus Jr, Edward A can be contacted via phone (309) 691-7890.Contact Information
Primary practice address
5401 N Knoxville Ave Suite 306
Peoria IL 61614-5098
Phone: (309) 691-7890
Fax: (309) 691-7898
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 036073126 | Illinois |
Profile Details
| NPI number | 1871597450 |
|---|---|
| LBN Legal business name | Rufus Jr, Edward A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 10th, 2005 |
| Last updated | Oct 14th, 2009 - about 17 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 | 1871597450 | NPPES |
| Illinois | MEDICAID | 036073126 | |
| Illinois | Other | 7200599 |
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