# PRAIRIE SURGICARE, LLC

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

## Provider details

- **NPI number:** 1336408038
- **Authorized official:** DR. RICHARD KUBE II MD, FACSS (OWNER/MEDICAL DIRECTOR)
- **Authorized official phone:** (309) 691-7774

## Contact information

- **Practice address:** 7620 N UNIVERSITY ST, SUITE 101, PEORIA, IL 61614-8300
- **Practice address phone:** (309) 691-7774
- **Practice address fax:** (309) 689-5768
- **Mailing address:** 7620 N UNIVERSITY ST, SUITE 101, PEORIA, IL 61614-8300
- **Mailing address phone:** (309) 691-7774
- **Mailing address fax:** (309) 689-5768

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/15/2012
- **Last updated:** 05/15/2012