# TEVERBAUGH CROLAND AND MUELLER OB/GYN AND ASSOCIATES, S.C.

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

## Provider details

- **NPI number:** 1669840575
- **Authorized official:** JANELL M PETTRY (OFFICE MANAGER)
- **Authorized official phone:** (309) 621-4604

## Contact information

- **Practice address:** 8600 N STATE ROUTE 91, SUITE 330, PEORIA, IL 61615-9541
- **Practice address phone:** (309) 692-2025
- **Mailing address:** 8600 N STATE ROUTE 91, SUITE 330, PEORIA, IL 61615-9541
- **Mailing address phone:** (309) 692-2025

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 367A00000X | Advanced Practice Midwife | 209013293 | IL | Yes |

## Other

- **Enumeration date:** 09/09/2015
- **Last updated:** 09/09/2015