PERU PRIMARY CARE PROFESSIONALS LLC
Medical Practice at West St, Peru, IL

License number
Illinois 036111100
Category
Osteopathic Medicine
Type
Family Medicine
License number
Illinois 036089936
Category
Osteopathic Medicine
Type
Internal Medicine
License number
Illinois 036089936
Category
Osteopathic Medicine
Type
Geriatric Medicine
License number
Illinois 036089936
Category
Medical Practice
Type
Pediatrics
Owner
Name: MARK A. FERNANDEZ M.D.
Title: PARTNER
Phone: (815) 223-9214
Address
Address
920 West St WEST SUITE 311, Peru, IL 61354
National Provider ID: 1568591048
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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PERU PRIMARY CARE PROFESSIONALS, LLC

920 W St, Peru, IL 61354

Status:
Inactive
Industry:
Medical Doctor's Office
Doing business as:
Peru Primary Care Professionals
Registration:
Mar 19, 2007
State ID:
02147653
Business type:
Domestic LLC
Expiration:
PERPETUAL
Family Practitioners:
Katie Korn (Office Manager),Mark Fernandez (Internal Medicine, Partner),Carolyn Anne Sullivan (Ac Pnp , Physician Assistant),...
Agent:
John S Duncan,PO Box 539, La Salle, IL 61301 (Physical)

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