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Dr. Wayne Kenneth Manness, MD
Diagnostic Radiology Physician in Peoria, Illinois
NPI 1710936497

Wayne Kenneth Manness is a Diagnostic Radiology Physician based in East Peoria, IL and is specialized in Diagnostic Radiology. Wayne Kenneth Manness practices in Peoria, IL and has the professional credentials of MD. The NPI Number for Wayne Kenneth Manness is 1710936497 and holds a License No. 0101242387 (Illinois).

The current practice location address for Wayne Kenneth Manness is 530 Ne Glen Oak Ave, Peoria, IL and can be reached out via phone at 309-655-2000.

Location: 530 Ne Glen Oak Ave, Peoria, IL, 61611-1853
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1710936497
Provider Name
Wayne Kenneth Manness
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
530 Ne Glen Oak Ave, Peoria, IL, 61611-1853
Phone Number
309-655-2000
Fax Number
Provider Enumeration Date
05/09/2006
Last Update Date
04/13/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
036099816 05 IL
212545 01 IL GROUP PTAN
202926 01 IL GROUP PTAN
institution
Provider Business Practice Location Address Details
Address
530 Ne Glen Oak Ave
City
Peoria
State
Illinois
Zip
61637-0914
Phone Number
309-655-2000
Fax Number
person
Provider Business Mailing Address Details
Address
530 Ne Glen Oak Ave
City
Peoria
State
Illinois
Zip
61637-0914
Phone Number
309-655-2000
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Diagnostic Radiology
Taxonomy
2085R0202X
License No.
0101242387 (Virginia)
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
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