# PROCTOR HEALTH SYSTEMS

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PROCTOR HEALTH SYSTEMS
- **Other names:** PROCTOR MEDICAL GROUP SURGERY - C K SONG MD
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1720223837
- **Legal business name:** PROCTOR HEALTH SYSTEMS
- **Authorized official:** DENISE BRINKER (SYSTEM ANALYST)
- **Authorized official phone:** (390) 689-6089

## Contact information

- **Practice address:** 5401 N KNOXVILLE AVE, STE 217, PEORIA, IL 61614-5098
- **Practice address phone:** (309) 691-1092
- **Mailing address:** 5401 N KNOXVILLE AVE, STE 209, PEORIA, IL 61614-5098
- **Mailing address phone:** (309) 691-1092
- **Mailing address fax:** (309) 689-6092

## Taxonomy

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

## Other

- **Enumeration date:** 12/04/2008
- **Last updated:** 12/04/2008