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Individual

WILLIAM C EBY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
221 NE GLEN OAK AVE, PEORIA, IL 61636-0001
(309) 672-4918
Mailing address
PO BOX 9578, PEORIA, IL 61612-9578

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0360508421
IL
Enumeration date
05/22/2006
Last updated
07/12/2007
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