Individual
DR. PHILIP JAMES MEAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
180 S MAIN ST, CANTON, IL 61520-2608
(309) 672-5682
(309) 672-3147
Mailing address
3402 N PEORIA AVE, PEORIA, IL 61603-1124
(912) 507-2079
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036156939
IL
207RP1001X
Pulmonary Disease Physician
Primary
036156939
IL
390200000X
Student in an Organized Health Care Education/Training Program
125071877
IL
Other
Enumeration date
07/01/2018
Last updated
04/18/2025
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