Individual
AGUSTIN BELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4775 E MARYLAND ST, DECATUR, IL 62521-8820
(217) 864-3737
(217) 876-1890
Mailing address
PO BOX 3428, SPRINGFIELD, IL 62708-3428
(217) 864-3737
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01094341A
IN
207Q00000X
Family Medicine Physician
Primary
036133064
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036133064
MD LICENSE
IL
Enumeration date
06/18/2010
Last updated
09/18/2024
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