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Individual

EDWARD W PEGG III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2204 EASTLAND DR, BLOOMINGTON, IL 61704-3567
(309) 661-6900
Mailing address
2204 EASTLAND DR, BLOOMINGTON, IL 61704-3567

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
036071077
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036071077
IL
Enumeration date
10/19/2006
Last updated
04/26/2024
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