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Individual

DR. DENNIS ALAN PEACOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1333 W BELMONT AVE STE 100, CHICAGO, IL 60657
(312) 694-2273
(312) 694-1875
Mailing address
680 N. LAKE SHORE DRIVE, CHICAGO, IL 60611-2987
(312) 695-6868

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036.141382
IL
207R00000X
Internal Medicine Physician
200700
LA
208000000X
Pediatrics Physician
036.141382
IL
208000000X
Pediatrics Physician
200700
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
05024018
MS
05
1073849
LA
Enumeration date
05/11/2007
Last updated
05/27/2022
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