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Dr. Dennis D Costerisan, DO
Family Medicine Physician in Decatur, Illinois
NPI 1578565701

Dennis D Costerisan is a Family Medicine Physician based in Decatur, IL. Dennis D Costerisan practices in Decatur, IL and has the professional credentials of DO. The NPI Number for Dennis D Costerisan is 1578565701 and holds a License No. 036071025 (Illinois).

The current practice location address for Dennis D Costerisan is 320 E Central Ave, Decatur, IL and can be reached out via phone at 217-877-9117 and via fax at 217-877-3078.

Location: 320 E Central Ave, Decatur, IL, 62521-4665
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1578565701
Provider Name
Dennis D Costerisan
Credential
DO
Provider Entity Type
Individual
Gender
Male
Address
320 E Central Ave, Decatur, IL, 62521-4665
Phone Number
217-877-9117
Fax Number
217-877-3078
Provider Enumeration Date
06/01/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
080105720 01 IL RAILROAD MEDICARE
178026 01 IL HEALTHLINK
0360710252 05 IL
0007005197 01 IL BLUE CROSS BLUE SHIELD
institution
Provider Business Practice Location Address Details
Address
320 E Central Ave
City
Decatur
State
Illinois
Zip
62521-4665
Phone Number
217-877-9117
Fax Number
217-877-3078
person
Provider Business Mailing Address Details
Address
320 E Central Ave
City
Decatur
State
Illinois
Zip
62521-4665
Phone Number
217-877-9117
Fax Number
217-877-3078
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
-
Taxonomy
207Q00000X
License No.
036071025 (Illinois)
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
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