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DAVID RODENBERG NPI 1417038860


NPI Information

NPI: 1417038860
Provider Name: DAVID RODENBERG
Classification: Internal Medicine - 207R00000X
Entity Type: Individual
Address:
200 E PENNSYLVANIA AVE
PEORIA, IL
ZIP 61603
Phone: (309) 655-7990
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David Rodenberg is an internal medicine in Peoria, IL. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. David Rodenberg NPI is 1417038860. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

200 E PENNSYLVANIA AVE
PEORIA, IL
ZIP 61603-089
Phone: (309) 655-7990
Fax: (309) 655-7953

The enumeration date for this NPI number is 10/18/2006 and was last updated on 7/8/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal MedicineILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1110122399 - CA4079MEDICARE ID-TYPE UNSPECIFIEDILLINOISRR
2B29086MEDICARE UPIN
3L36569MEDICARE ID-TYPE UNSPECIFIEDILLINOISINDIVIDUAL #
4809840MEDICARE ID-TYPE UNSPECIFIEDILLINOISGROUP #

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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