Individual
EDWARD CABALLERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
311 W FAIRCHILD ST, DANVILLE, IL 61832-3876
(217) 431-7600
Mailing address
611 W. PARK ST., FAPC, URBANA, IL 61801
(908) 249-3967
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036148315
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/07/2016
Last updated
03/02/2020
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