Individual
PATRICIA A DETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2265 W ALTORFER DR, PEORIA, IL 61615-1807
(309) 683-7700
(309) 683-7752
Mailing address
2265 W ALTORFER DR, PEORIA, IL 61615-1807
(309) 683-7700
(309) 683-7752
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
036095780
IL
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
036095780
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036095780
—
IL
Enumeration date
06/24/2006
Last updated
07/23/2019
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