Provider Demographics
NPI:1336104884
Name:MORRELL RIECH, TERESA JEAN (MD)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:JEAN
Last Name:MORRELL RIECH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:JEAN
Other - Last Name:RIECH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:530 NE GLEN OAK AVE
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61637-0001
Mailing Address - Country:US
Mailing Address - Phone:309-655-2553
Mailing Address - Fax:309-655-2602
Practice Address - Street 1:530 NE GLEN OAK AVE
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61637-5402
Practice Address - Country:US
Practice Address - Phone:309-655-2553
Practice Address - Fax:309-655-2602
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01059317A207R00000X, 208000000X
IL036118982208000000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics