Individual
JOHN CARROLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2727 W HEADING AVE, WEST PEORIA, IL 61604-4981
(309) 648-1087
Mailing address
2727 W HEADING AVE, WEST PEORIA, IL 61604-4981
(309) 648-1087
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036.064215
IL
Other
Enumeration date
09/24/2010
Last updated
09/24/2010
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