Individual
NICHOLAS JAMES ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
900 MAIN ST, PEORIA, IL 61602-1005
(309) 672-3100
Mailing address
221 NE GLEN OAK AVE, PEORIA, IL 61636-0001
(309) 672-4974
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036.161219
IL
Other
Enumeration date
04/23/2019
Last updated
02/07/2025
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