Organization
PROCTOR COMMUNITY HOSPITAL
Active
Other names
Proctor Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBORAH R. SIMON (PRESIDENT/CEO)
(309) 672-5928
Entity
Organization
Contact information
Practice address
5409 N KNOXVILLE AVE, PEORIA, IL 61614-5016
(309) 691-1000
(309) 671-8265
Mailing address
5409 N KNOXVILLE AVE, PEORIA, IL 61614-5016
(309) 672-4813
(309) 671-8265
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
0001925
IL
282N00000X
General Acute Care Hospital
1677264
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0117
BLUE CROSS
IL
Enumeration date
07/07/2005
Last updated
01/23/2015
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