Bloomington Normal Healthcare, Llc

NPI 1083613327 - Clinic/Center - 261QA1903X

NPI Details
NPI 1083613327
Enumeration Date 07/19/2005
Last Updated 04/20/2008
Entity Type Healthcare Provider
Active Over 12 years ago
Authorized Information
Name THOMAS B THOMAS
Position PHYSICIAN/OWNER
Phone (309) 834-4000
Fax (309) 834-4007
Practice Location
2100 FORT JESSE RD
NORMAL IL, 61761-9370, US
Phone (309) 834-4000
Fax (309) 834-4007
Business Location
2100 FORT JESSE RD
NORMAL IL, 61761-9370, US
Phone (309) 834-4000
Fax (309) 834-4007
Toxanomy
Taxonomy Code 261QA1903X
License State Illinois
License Number 7002512
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According to our database, Bloomington Normal Healthcare, Llc NPI is 1083613327, taxonomy code is 261QA1903X and license number is 7002512, license state is located at Illinois. Bloomington Normal Healthcare, Llc physically located at 2100 Fort Jesse Rd, Normal IL, 61761-9370. NPI Number 1033115704 has the healthcare provider type.

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1083613327 NPI number is provided on an as is basis without warranty of any kind. 1083613327 is maintained by the National Plan & Provider Enumeration System. The contents of Bloomington Normal Healthcare, Llc are for informational purposes only.