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Individual

LINDEN R PEARSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4230 LINCOLNSHIRE DR STE G, MOUNT VERNON, IL 62864-2189
(618) 244-6770
(618) 244-6772
Mailing address
4230 LINCOLNSHIRE DR STE G, MOUNT VERNON, IL 62864-2189
(618) 244-6770
(618) 244-6772

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036063418
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036063418
IL
01
04127526
BCBS
IL
01
080168274
MEDICARE RAILROAD NUMBER
IL
01
174857
HEALTHLINK PPO HMO
IL
Enumeration date
12/12/2006
Last updated
08/12/2015
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