Illinois Gastroenterology Institute, S.c.

NPI 1275575706 - Internal Medicine - 207RG0100X

NPI Details
NPI 1275575706
Enumeration Date 06/11/2006
Last Updated 06/11/2015
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name MIKE MIKE
Position ADMINISTRATOR
Phone (309) 672-4980
Fax (309) 671-2944
Practice Location
1001 MAIN ST
SUITE 500A
PEORIA IL, 61606-1907, US
Phone (309) 672-4980
Fax (309) 671-2944
Business Location
PO BOX 365
MORTON IL, 61550-0365, US
Phone (309) 672-4980
Fax (309) 671-2944
Toxanomy
Taxonomy Code 207RG0100X
License State Illinois
License Number 042006270
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According to our database, Illinois Gastroenterology Institute, S.c. NPI is 1275575706, taxonomy code is 207RG0100X and license number is 042006270, license state is located at Illinois. Illinois Gastroenterology Institute, S.c. physically located at 1001 Main St, Peoria IL, 61606-1907. NPI Number 1033115704 has the healthcare provider type.

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1275575706 NPI number is provided on an as is basis without warranty of any kind. 1275575706 is maintained by the National Plan & Provider Enumeration System. The contents of Illinois Gastroenterology Institute, S.c. are for informational purposes only.