Individual
MEREDITH VIOLET LAGOUROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
9010 N ALLEN RD, PEORIA, IL 61615-1573
(309) 495-8500
Mailing address
9010 N ALLEN RD, NONE, PEORIA, IL 61615-1573
(309) 495-8500
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036.136776
IL
Other
Enumeration date
06/28/2010
Last updated
08/07/2015
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