Individual
EVAN C PIKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8921 N WOOD SAGE RD, PEORIA, IL 61615-7822
(309) 243-2400
Mailing address
8921 N WOOD SAGE RD, PEORIA, IL 61615-7822
(309) 243-2400
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
036132250
IL
207W00000X
Ophthalmology Physician
35099461
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0068330
—
OH
Enumeration date
06/26/2008
Last updated
07/28/2020
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