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Organization
INTERIM HEALTHCARE OF DOWNSTATE ILLINOIS
Active
Organization
INTERIM HEALTHCARE OF DOWNSTATE ILLINOIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KYLE COLGAN RN (CLINICAL SUPERVISOR)
(309) 696-3822
Entity
Organization
Contact information
Practice address
1223 W PIONEER PKWY, PEORIA, IL 61615-1936
(309) 296-0056
Mailing address
1223 W PIONEER PKWY, PEORIA, IL 61615-1936
(309) 296-0056
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
01/11/2022
Last updated
01/11/2022
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