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Individual
DR. RAYMOND WILLIAM PRYOR III
Active
Individual
DR. RAYMOND WILLIAM PRYOR III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036124770
IL
208600000X
Surgery Physician
036124770
IL
208D00000X
General Practice Physician
036124770
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036124770
—
IL
01
—
P00847866
RAILROAD MEDICARE
IL
Enumeration date
01/05/2010
Last updated
06/29/2011
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