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Organization
METHODIST
Active
Organization
METHODIST
Active
Other names
Unitypoint Health Methodist
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTOPHER LEGAN LCPC (PHP THERAPIST)
(309) 672-5604
Entity
Organization
Contact information
Practice address
221 NE GLEN OAK AVE, PEORIA, IL 61636-0001
(309) 672-5604
Mailing address
221 NE GLEN OAK AVE, PEORIA, IL 61636-0001
(309) 672-5604
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180007159
LCPC
IL
Enumeration date
06/10/2020
Last updated
06/10/2020
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