Individual
JOSEPH PEABODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1775 DEMPSTER ST, PARK RIDGE, IL 60068-1143
(847) 723-7624
Mailing address
1775 DEMPSTER ST, PARK RIDGE, IL 60068-1143
(847) 723-7624
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036098139
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036098139
—
IL
Enumeration date
11/07/2006
Last updated
02/20/2023
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