Organization
GREGORY L. TOTEL, M.D.,S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY LEE TOTEL M.D. (PRESIDENT)
(217) 875-1090
Entity
Organization
Contact information
Practice address
1 MEMORIAL DR STE 201, DECATUR, IL 62526-6317
(217) 875-1090
(217) 875-1099
Mailing address
1 MEMORIAL DR STE 201, DECATUR, IL 62526-6317
(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 SHEILD
IL
Enumeration date
09/17/2010
Last updated
09/17/2010
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