Individual
JOHN JOSEPH FARRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
DEPARTMENT OF INTERNAL MEDICINE, 530 NE GLEN OAK DRIVE, PEORIA, IL 61637-0001
(309) 655-7734
Mailing address
723 NE GLEN OAK AVE, PEORIA, IL 61603-3252
(309) 624-8749
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
036111223
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036111223
—
IL
01
—
07215036
BCBS
IL
01
—
IL0104
JOHN DEERE
IL
Enumeration date
02/13/2006
Last updated
08/05/2011
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