Organization
MID ILLINI SURGICAL ASSOCIATES SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREG TOTTEN (OFFICE MANAGER)
(309) 672-5975
Entity
Organization
Contact information
Practice address
900 MAIN ST, SUITE 530, PEORIA, IL 61602-1074
(309) 672-5975
(309) 655-1678
Mailing address
900 MAIN STREET, SUITE 530, PEORIA, IL 61602-1074
(309) 672-5975
(309) 655-1678
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
IL
Other
Enumeration date
02/06/2007
Last updated
07/21/2022
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