Individual
DR. CARL BOHM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 655-2109
Mailing address
530 NE GLEN OAK AVE, PEORIA, IL 61637-4909
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2021-01331
NC
207P00000X
Emergency Medicine Physician
2024024643
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/04/2018
Last updated
10/07/2024
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