Individual
DR. RICHARD PEARL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
420 NE GLEN OAK AVE, STE 201, PEORIA, IL 61603-3105
(309) 655-3800
Mailing address
420 NE GLEN OAK AVE, STE 201, PEORIA, IL 61603-3105
(309) 655-3800
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
036098051
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036098051-2
—
IL
01
—
7215166
BCBS
IL
Enumeration date
06/29/2006
Last updated
07/08/2007
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