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Organization
ILLINOIS GASTROENTEROLOGY INSTITUTE, PLLC
Active
Organization
ILLINOIS GASTROENTEROLOGY INSTITUTE, PLLC
Active
Parent organization
ILLINOIS GASTROENTEROLOGY INSTITUTE, PLLC
Other names
Peoria Anesthesia Service
Organization subpart
Yes
Provider details
NPI number
Legal business name
ILLINOIS GASTROENTEROLOGY INSTITUTE, PLLC
Authorized official
TERRY L BALDWIN (MD)
(309) 672-4980
Entity
Organization
Contact information
Practice address
1001 MAIN ST STE 500A, PEORIA, IL 61606-2038
(309) 495-1121
Mailing address
1001 MAIN ST STE 500A, PEORIA, IL 61606-2038
(309) 495-1121
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
NULL
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
NULL
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
06/29/2018
Last updated
08/17/2020
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