Individual
MR. PETER ANGELO KEORPES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
374 LARRY POWER RD, BOURBONNAIS, IL 60914-5187
(815) 933-2227
(815) 933-5278
Mailing address
820 SPRINGER DR, LOMBARD, IL 60148-6413
(815) 933-2227
(815) 933-5278
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
085.004041
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
085.004041
STATE LICSENSE
IL
Enumeration date
07/17/2009
Last updated
11/04/2017
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