Individual
DR. ANDREW MARK VENTURELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8600 N STATE ROUTE 91, SUITE 250, PEORIA, IL 61615-9541
(309) 692-5393
(309) 692-2538
Mailing address
8600 N STATE ROUTE 91, SUITE 250, PEORIA, IL 61615-9541
(309) 692-5393
(309) 692-2538
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036127631
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0
PENDING
IL
Enumeration date
06/29/2007
Last updated
08/10/2011
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