Smalley, James R

Smalley, James R is an individual health care provider with primary practice located at 5405 N Knoxville Ave , Peoria IL 61614. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Smalley, James R can be contacted via phone (309) 691-4410.

Contact Information

Primary practice address
5405 N Knoxville Ave Peoria IL 61614
Phone: (309) 691-4410
Fax: (309) 589-2830
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 036078869 Illinois

Profile Details

NPI number 1356375638
LBN Legal business name Smalley, James R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 10th, 2006
Last updated Aug 18th, 2010 - about 15 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 1356375638 NPPES
Illinois MEDICAID 036078869

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