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Organization
BOYD OBSTETRICS & GYNECOLOGY OF CENTRAL ILLINOIS
Active
Organization
BOYD OBSTETRICS & GYNECOLOGY OF CENTRAL ILLINOIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA CLARK (ADMINISTRATOR)
(309) 687-4242
Entity
Organization
Contact information
Practice address
900 MAIN ST STE 660, PEORIA, IL 61602-1060
(309) 687-4230
(309) 687-4235
Mailing address
900 MAIN ST STE 660, PEORIA, IL 61602-1060
(309) 687-4230
(309) 687-4235
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036084069
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008992
HEALTH ALLIANCE
IL
05
—
036084069
—
IL
01
—
263252
HEALTHLINK
IL
01
—
4623406
AETNA
IL
01
—
7205412
BCBS
IL
Enumeration date
11/10/2010
Last updated
11/10/2010
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