Dr. Richard D. Corley, S.c.

NPI #1538498209 in Peoria, Illinois

Provider Information

NPI Number: 1538498209
Entity Type: Organization
Organization Name: Dr. Richard D. Corley, S.c.
Primary Specialty: Plastic Surgery
Enumeration Date: Dec 9, 2009
Last Updated: Dec 9, 2009

Practice Location

Address: 416 ST. MARK CT.
Address 2: #106
City: Peoria
State: Illinois
ZIP Code: 61603-1928
Phone: (309) 674-2822

Authorized Official

Name: RICHARD D. CORLEY, M.D.
Title: DIRECT OWNER
Phone: (309) 674-2822

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Plastic Surgery	208200000X	Primary

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