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Organization
OSF MULTISPECIALTY GROUP - EASTERN REGION, LLC
Active
Organization
OSF MULTISPECIALTY GROUP - EASTERN REGION, LLC
Active
Parent organization
OSF HEALTHCARE SYSTEM
Other names
OSF Medical Group - College Avenue
Organization subpart
Yes
Provider details
NPI number
Legal business name
OSF HEALTHCARE SYSTEM
Authorized official
MR. JAMES M MOORE (CEO)
(309) 655-2850
Entity
Organization
Contact information
Practice address
1701 E COLLEGE AVE, BLOOMINGTON, IL 61704-2101
(309) 664-3280
Mailing address
800 NE GLEN OAK AVE, PEORIA, IL 61603-3255
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RP1001X
Pulmonary Disease Physician
—
—
207T00000X
Neurological Surgery Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
207Y00000X
Otolaryngology Physician
—
—
208000000X
Pediatrics Physician
—
—
2083X0100X
Occupational Medicine Physician
—
—
2084P0800X
Psychiatry Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
208800000X
Urology Physician
—
—
208C00000X
Colon & Rectal Surgery Physician
—
—
208M00000X
Hospitalist Physician
—
—
Other
Enumeration date
06/22/2009
Last updated
06/22/2009
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