Organization
CENTRAL ILLINOIS ALLERGY AND RESPIRATORY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GLENNON H PAUL M.D. (PRESIDENT)
(217) 522-5596
Entity
Organization
Contact information
Practice address
543 W MILLER ST, SPRINGFIELD, IL 62702-4978
(217) 522-5596
(217) 522-5599
Mailing address
543 W MILLER ST, SPRINGFIELD, IL 62702-4978
(217) 522-5596
(217) 522-5599
Taxonomy
Speciality
Code
Description
License number
State
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
Primary
—
IL
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
IL
207RP1001X
Pulmonary Disease Physician
—
IL
Other
Enumeration date
05/12/2006
Last updated
10/04/2007
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