Organization
CENTRAL ILLINOIS PATHOLOGY, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL P HAYES M.D. (ADMINISTRATOR)
(309) 624-9011
Entity
Organization
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 624-9011
(309) 624-9152
Mailing address
10335 N PORT WASHINGTON RD, SUITE 250, MEQUON, WI 53092-5763
(262) 240-9870
(262) 240-9869
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Enumeration date
05/17/2006
Last updated
10/30/2007
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