Individual
RONALD A. VIDAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1107 COLLEGE AVE, QUINCY, IL 62301-2664
(217) 222-3377
(217) 228-2657
Mailing address
1107 COLLEGE AVE, QUINCY, IL 62301-2664
(217) 222-3377
(217) 228-2657
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
109299
HEALTH ALLIANCE
IL
Enumeration date
07/27/2006
Last updated
07/08/2007
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