Individual
DR. LUIS C DEVENECIA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1120 N EAST ST, OLNEY, IL 62450-6927
(618) 395-5222
(618) 395-8552
Mailing address
1120 N EAST ST, OLNEY, IL 62450-6927
(618) 395-5222
(618) 395-8552
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036091236
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036091236
—
IL
01
—
063073
HEALTH ALLIANCE
IL
01
—
296286
HEALTH LINK
IL
Enumeration date
08/18/2006
Last updated
08/29/2024
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