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LESTEL ESCORCIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
8914 N KNOXVILLE AVE, PEORIA, IL 61615-1410
(309) 691-9110
Mailing address
5100 RELIABLE PKWY, CHICAGO, IL 60686-0001
(309) 672-4809

Taxonomy

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

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0360950101
IL
01
040273
HEALTH ALLIANCE
IL
01
472307
HEALTHLINK
IL
01
7215059
BCBS PPO
IL
01
IL01N5
JOHN DEERE
IL
Enumeration date
07/28/2006
Last updated
07/08/2007
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