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Organization

ILLINOIS VALLEY RADIOLOGY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARK HILBORN MD (PRESIDENT)
(815) 673-2311
Entity
Organization

Contact information

Practice address
111 SPRING ST, STREATOR, IL 61364-3332
(815) 673-2311
Mailing address
4234 N BRANDYWINE DR, PEORIA, IL 61614-5566
(866) 286-5887

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
05023282
BC BS
IL
Enumeration date
07/15/2005
Last updated
04/20/2008
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