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Alan Debord, MD
Specialist in Peoria, Illinois
NPI 1902864796

Alan Debord is a Specialist based in Peoria, IL. Alan Debord practices in Peoria, IL and has the professional credentials of MD. The NPI Number for Alan Debord is 1902864796 and holds a License No. 036055826 (Illinois).

The current practice location address for Alan Debord is 200 E Pennsylvania Ave, Peoria, IL and can be reached out via phone at 309-655-2045 and via fax at 309-655-3057.

Location: 200 E Pennsylvania Ave, Peoria, IL, 61603-3089
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1902864796
Provider Name
Alan Debord
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
200 E Pennsylvania Ave, Peoria, IL, 61603-3089
Phone Number
309-655-2045
Fax Number
309-655-3057
Provider Enumeration Date
05/02/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
809840 01 IL MEDICARE GROUP PTAN
CA4079 01 IL RR MEDICARE GROUP PTAN
P00651196 01 IL RR MEDICARE MEMBER PTAN
036055826 05 IL
institution
Provider Business Practice Location Address Details
Address
200 E Pennsylvania Ave
City
Peoria
State
Illinois
Zip
61603-3089
Phone Number
309-655-2045
Fax Number
309-655-3057
person
Provider Business Mailing Address Details
Address
200 E Pennsylvania Ave
City
Peoria
State
Illinois
Zip
61603-3089
Phone Number
309-655-2045
Fax Number
309-655-3057
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
036055826 (Illinois)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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