Individual
DR. DALE R CHILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O
Contact information
Practice address
4040 PROGRESS BLVD, PERU, IL 61354-1124
(815) 224-3040
(815) 224-4327
Mailing address
600 E 1ST ST, SPRING VALLEY, IL 61362-1512
(815) 224-3040
(815) 224-4327
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
Primary
036096113
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036096113
—
IL
Enumeration date
08/13/2006
Last updated
08/25/2008
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