Individual
LARRY LINDAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
320 E ARMSTRONG AVE, PEORIA, IL 61603
(309) 680-7600
(309) 681-8443
Mailing address
2214 N UNIVERSITY ST, PEORIA, IL 61604
(309) 680-7600
(309) 681-8620
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036-061295
IL
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
036-061295
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036061295
—
IL
Enumeration date
09/21/2006
Last updated
11/26/2014
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