Individual
DR. CLARISSA RHODE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 655-2000
Mailing address
PO BOX 3853, PEORIA, IL 61612-3853
(800) 899-5757
(314) 821-1833
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036-086691
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0007222342
BLUE CROSS BLUE SHIELD
IL
05
—
036086691-1
—
IL
01
—
056202
HEALTH ALLIANCE
IL
01
—
296047
HEALTHLINK
IL
01
—
300065444
RAILROAD MEDICARE
IL
01
—
3533684
ACR
IL
01
—
370947902
TRICARE CHAMPUS
IL
01
—
IL0100
JOHN DEER
IL
Enumeration date
01/03/2006
Last updated
01/23/2024
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