Organization
TCOM SPECIALTY PHYSICIANS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH GARDNER (BUSINESS DIRECTOR)
(309) 662-6120
Entity
Organization
Contact information
Practice address
2502 E EMPIRE ST STE B, BLOOMINGTON, IL 61704
(309) 662-6120
Mailing address
PO BOX 775737, CHICAGO, IL 60677-5737
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
06/01/2018
Last updated
06/21/2018
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