Individual
MR. JOHN W MCCLEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
834 N SEMINARY ST, STE 502, GALESBURG, IL 61401-2852
(309) 343-2262
(309) 343-2081
Mailing address
834 N SEMINARY ST, STE 502, GALESBURG, IL 61401-2852
(309) 343-2262
(309) 343-2081
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
036059602
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036059602
—
IL
01
—
039664
HEALTH ALLIANCE PROV #
IL
01
—
04823538
BCBS GROUP #
IL
01
—
340017813
RR MEDICARE PROV #
IL
01
—
693762
HEALTHLINK PROV #
IL
01
—
IL0103
JOHN DEERE PROV #
IL
Enumeration date
07/07/2005
Last updated
07/08/2007
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