# WEST CENTRAL ALLERGY CENTER S.C.

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

## Provider details

- **NPI number:** 1780863910
- **Authorized official:** DANILO GUNGON CAPATI M.D. (PRESIDENT)
- **Authorized official phone:** (309) 685-1038

## Contact information

- **Practice address:** 2514 W SCENIC DR, PEORIA, IL 61615-3825
- **Practice address phone:** (309) 685-1038
- **Mailing address:** 2514 W SCENIC DR, PEORIA, IL 61615-3825
- **Mailing address phone:** (309) 685-1038

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | IL | Yes |

## Other

- **Enumeration date:** 10/24/2007
- **Last updated:** 02/05/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0007232040 | BLUE CROSS BLUE SHIELD | IL |