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Contact Information

RICHARD S SEABOCH, PA
5405 N KNOXVILLE AVE
PEORIA, IL61614
 Phone: 309-691-4410
 Fax: 309-589-2830
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
 

Surgical

363AS0400X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for RICHARD S SEABOCH · (Male)

NPI Number 1043227846
Status Active
Credentials PA (Physician Assistant)
Entity Individual
Enumeration date 08/02/2006
Last updated 08/31/2010 - About 16 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 085001201
  • IL Medicaid 085001201
Hospital affiliation(s)
  • SAINT FRANCIS MEDICAL CENTER - (Acute Care)
    530 NE GLEN OAK AVE
    PEORIA, IL 61637
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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