Individual
DR. DONALD E PENN JR.
Active
Individual
DR. DONALD E PENN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
036062844
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008850
HEALTH ALLIANCE
IL
05
—
036062844
—
IL
01
—
07215152
BLUE CROSS
IL
01
—
100004399
RAILROAD MEDICARE
IL
01
—
166330
HEALTHLINK
IL
01
—
371221637
FEDERAL TAX IDENTIFICATIO
IL
01
—
4282553
AETNA HEALTH PLANS
IL
01
—
776530
MEDICARE GROUP NUMBER
IL
01
—
IL0101
JOHN DEERE
IL
Enumeration date
06/15/2006
Last updated
05/29/2009
Update your record
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