Individual
MICHAEL M RASO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1115 N BOURLAND AVE, PEORIA, IL 61606-1210
(309) 264-0730
Mailing address
1115 N BOURLAND AVE, PEORIA, IL 61606-1210
(309) 264-0730
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036117194
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036117194
STATE MEDICAL LICENSE
IL
Enumeration date
07/02/2007
Last updated
07/08/2007
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