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Individual

LARRY H DE PEDRO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
705 S DIXIE HWY, HOOPESTON, IL 60942-1904
(217) 283-5530
Mailing address
1120 N MELVIN ST, GIBSON CITY, IL 60936-1477
(217) 283-5530

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-116088
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036116088
IL
Enumeration date
07/27/2006
Last updated
08/12/2020
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