Individual
ANDREW S REESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
6000 N ALLEN ROAD, PEORIA, IL 61614-3294
(309) 691-1400
Mailing address
6000 N ALLEN ROAD, PEORIA, IL 61614-3294
(309) 691-1400
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
085001887
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
085001887
—
IL
Enumeration date
10/14/2005
Last updated
12/31/2019
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