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Individual

DR. GERALD DEPEW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
3299 COURT ST, PEKIN, IL 61554-6208
(309) 347-2510
(309) 347-2502
Mailing address
3299 COURT ST, PEKIN, IL 61554-6208
(309) 346-2663
(309) 346-2680

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
09032059
BLUE CROSS BLUE SHIELD
IL
Enumeration date
05/23/2006
Last updated
07/08/2007
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