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Individual

DR. STEVEN E COVENTRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-1512
(309) 655-2000
Mailing address
111 OAKWOOD RD, EAST PEORIA, IL 61611-1853
(309) 740-4272

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036103336
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00615598
BCBS
05
036103336
IL
01
663210
MEDICARE ID
Enumeration date
11/27/2006
Last updated
10/23/2023
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