Individual
DR. CHURPHENA REID
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1001 MAIN ST, SUITE 201, PEORIA, IL 61606-1907
(309) 495-0282
(309) 495-0298
Mailing address
1001 MAIN ST, STE 201, PEORIA, IL 61606-1907
(309) 495-0282
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
036089160
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7215166
BCBS
IL
Enumeration date
06/27/2006
Last updated
09/18/2012
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