Individual
DR. REUBEN MARI VALENZUELA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1001 MAIN ST STE 611, PEORIA, IL 61606-1907
(309) 495-0200
(309) 676-6545
Mailing address
PO BOX 19248, SPRINGFIELD, IL 62794-9248
(217) 528-7541
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125058436
IL
207W00000X
Ophthalmology Physician
9045377-1205
UT
2084N0400X
Neurology Physician
Primary
036141397
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1922328103
—
UT
Enumeration date
06/10/2010
Last updated
12/30/2022
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