# ILLINOIS GASTROENTEROLOGY INSTITUTE, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ILLINOIS GASTROENTEROLOGY INSTITUTE, PLLC
- **Other names:** Peoria Anesthesia Service
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1649765835
- **Legal business name:** ILLINOIS GASTROENTEROLOGY INSTITUTE, PLLC
- **Authorized official:** TERRY L BALDWIN (MD)
- **Authorized official phone:** (309) 672-4980

## Contact information

- **Practice address:** 1001 MAIN ST STE 500A, PEORIA, IL 61606-2038
- **Practice address phone:** (309) 495-1121
- **Mailing address:** 1001 MAIN ST STE 500A, PEORIA, IL 61606-2038
- **Mailing address phone:** (309) 495-1121

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | Yes |
| 207L00000X | Anesthesiology Physician | — | — | Yes |
| 367500000X | Certified Registered Nurse Anesthetist | — | NULL | — |
| 367500000X | Certified Registered Nurse Anesthetist | — | — | — |

## Other

- **Enumeration date:** 06/29/2018
- **Last updated:** 08/17/2020