Individual
EDMUND THOMAS PEACOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1750 W HARRISON ST STE 108, CHICAGO, IL 60612-3825
(312) 942-7802
Mailing address
1750 W HARRISON ST STE 108, CHICAGO, IL 60612-3825
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
125.086315
IL
390200000X
Student in an Organized Health Care Education/Training Program
Primary
125.086315
IL
Other
Enumeration date
06/25/2025
Last updated
08/05/2025
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