Provider Demographics
NPI:1346276284
Name:BALDWIN, TERRY L (MD)
Entity Type:Individual
Prefix:DR
First Name:TERRY
Middle Name:L
Last Name:BALDWIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 365
Mailing Address - Street 2:
Mailing Address - City:MORTON
Mailing Address - State:IL
Mailing Address - Zip Code:61550-0365
Mailing Address - Country:US
Mailing Address - Phone:309-672-4980
Mailing Address - Fax:309-671-2944
Practice Address - Street 1:1001 W MAIN ST
Practice Address - Street 2:SUITE 500A
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61606-1276
Practice Address - Country:US
Practice Address - Phone:309-672-4980
Practice Address - Fax:309-671-2944
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036098368207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL100012347OtherRAILROAD MEDICARE
IL044490OtherHEALTH ALLIANCE
IL036098368Medicaid
ILIL0112OtherJOHN DEERE PEKIN
IL5105708OtherAETNA HEALTH PLANS
IL776530OtherMEDICARE GROUP
ILIL0111OtherJOHN DEERE
IL397797OtherHEALTHLINK
IL397797OtherHEALTHLINK
IL044490OtherHEALTH ALLIANCE