Individual
FELIPE PEREN ENRIQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2570 24TH ST, SUITE 124, ROCK ISLAND, IL 61201-5394
(309) 779-3670
(309) 779-3675
Mailing address
2570 24TH ST, SUITE 124, ROCK ISLAND, IL 61201-5394
(309) 779-3670
(309) 779-3675
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
036056321
IL
207RP1001X
Pulmonary Disease Physician
17408
NV
2278P1004X
Pulmonary Diagnostics Certified Respiratory Therapist
036056321
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0810037063
BCBS IL
—
05
—
1457305468
—
IL
01
—
P01070821
RR MEDICARE
IL
Enumeration date
05/22/2006
Last updated
08/08/2019
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