# SUSAN J COLE, MD & ASSOCIATES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083848188
- **Authorized official:** DR. SUSAN JOAN COLE MD (LEAD PHYSICIAN)
- **Authorized official phone:** (309) 691-2311

## Contact information

- **Practice address:** 5401 N KNOXVILLE AVE, SUITE 107, PEORIA, IL 61614-5098
- **Practice address phone:** (309) 691-2311
- **Practice address fax:** (309) 691-2320
- **Mailing address:** 5401 N KNOXVILLE AVE, SUITE 107, PEORIA, IL 61614-5098
- **Mailing address phone:** (309) 691-2311
- **Mailing address fax:** (309) 691-2320

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 036062798 | IL | Yes |

## Other

- **Enumeration date:** 05/05/2009
- **Last updated:** 05/05/2009