Individual
ALLAN C CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5409 N KNOXVILLE AVE, PEORIA, IL 61614-5016
(309) 691-1060
Mailing address
PO BOX 9578, PEORIA, IL 61612-9578
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
036047555
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0360475551
—
IL
01
—
220011323
RAILROAD MEDICARE
IL
Enumeration date
06/02/2006
Last updated
05/12/2011
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