Individual
GREGORY L TOTEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 MEMORIAL DR, SUITE 201, DECATUR, IL 62526-6303
(217) 875-1090
(217) 875-1099
Mailing address
1 MEMORIAL DR, SUITE 201, DECATUR, IL 62526-6303
(217) 875-1090
(217) 875-1099
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036068474
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036068474
—
IL
01
—
05822058
BLUE CROSS BLUE SHIELD
IL
Enumeration date
08/30/2006
Last updated
07/08/2007
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