Individual
DAVID J FLANDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1320 W BIRD BLVD, PEORIA, IL 61615-1406
(309) 360-0189
Mailing address
6446 N JAMESTOWN RD, PEORIA, IL 61615-2606
(309) 360-0189
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
036068713
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0360687131
—
IL
01
—
220011118
RAILROAD MEDICARE
IL
Enumeration date
06/02/2006
Last updated
07/13/2012
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