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Contact Information

FREEDOM R ANDAL, AGACNP
530 NE GLEN OAK AVE
PEORIA, IL61637-0001
 Phone: 309-655-2000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Acute Care

363LA2100X 50 Nurse Practitioner
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for FREEDOM R ANDAL · (Male)

NPI # 1770215840
Status Active
Credentials AGACNP
Entity Individual
Enumeration date 06/28/2022
Last updated 03/18/2024 - About 2 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 209025726
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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