Individual
ADEL F MINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
112 NE CRESCENT AVE, PEORIA, IL 61606-1901
(309) 672-4670
Mailing address
112 NE CRESCENT AVE, PEORIA, IL 61606-1901
(309) 672-4670
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036111050
IL
207RC0000X
Cardiovascular Disease Physician
036111050
IL
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
036111050
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036111050
LICENSE
IL
Enumeration date
07/13/2006
Last updated
05/01/2018
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