Individual
DAVID SLAGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
DEPT OF INTERNAL MEDICINE, 530 NE GLEN OAK, PEORIA, IL 61637-0001
(309) 655-3292
Mailing address
1 ILLINI DR, PEORIA, IL 61605-2576
(309) 671-8503
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
036086726
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036086726
—
IL
01
—
07215036
BCBS
IL
01
—
IL01G3
JOHN DEERE
IL
Enumeration date
03/14/2006
Last updated
06/17/2011
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