Jeffrey S Edwards
Obstetrician & Gynecologist
1305 6th St
Peru
, Illinois 61354-2759
Jeffrey S Edwards
Obstetrician & Gynecologist
1305 6th St
Peru
, Illinois 61354-2759
(815) 223-4095
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About
Features
Specialties
- Obstetrician & Gynecologist
Languages spoken
- English
Location
First Address
- Jeffrey S Edwards
- 920 West St Bldg B
- Peru, IL
- Zip : 61354-2763
- Fax : (815) 223-4095
- Phone : (815) 223-2944
Second Address
- Jeffrey S Edwards
- 1305 6th St
- Peru, IL
- Zip : 61354-2759
- Fax : (815) 780-4634
- Phone : (815) 780-5029
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207V00000X | Obstetrician & Gynecologist | 036.133706 | IL |
| N | 207V00000X | Obstetrician & Gynecologist | 4301046434 | MI |
National Provider Identifier
| NPI | 1013915958 |
|---|---|
| Provider Name | Jeffrey S Edwards |
| First Address | Peru, IL 61354-2763 |
| Second Address | Peru, IL 61354-2759 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 13/07/2005 |
| Last Update Date | 18/07/2014 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 036.113706 | STATE OF IL LICENSE (01) | IL |
| 1018463 | PREFERREDONE (01) | |
| 134K2ED | BCBS (01) | MN |
| 31563400 | (05) | WI |
| 3519335 | (05) | MI |
| A17689 | (02) | |
| JE046434 | BLUE CROSS BLUE SHIELD MI (01) | MI |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.