Individual
CARL PETER BIRK JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
302 W HAY ST, STE 140, DECATUR, IL 62526-4167
(217) 876-2730
(217) 876-2735
Mailing address
2300 N EDWARD ST, GSBLL, DECATUR, IL 62526-4163
(217) 876-2730
(217) 876-2735
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036042482
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036042482
—
IL
Enumeration date
04/26/2006
Last updated
10/10/2008
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