Individual
DR. BENJAMIN DAVID LEMOINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 655-2000
Mailing address
111 OAKWOOD RD, EAST PEORIA, IL 61611-1853
(309) 740-4272
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036-147348
IL
2085R0202X
Diagnostic Radiology Physician
35.134522
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0307416
—
OH
05
—
1035443860001
—
PA
Enumeration date
04/11/2010
Last updated
01/03/2024
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