Individual
JOHN R LINDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
19 OLT AVE, PEKIN, IL 61554-6216
(309) 353-6301
(309) 353-1555
Mailing address
19 OLT AVE, PEKIN, IL 61554-6216
(309) 353-6301
(309) 353-1555
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036075387
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036075387
—
IL
01
—
09015685
BLUE CROSS BLUE SHIELD
IL
01
—
110154966
RAIL ROAD MEDICARE
IL
Enumeration date
05/17/2006
Last updated
03/24/2008
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