Organization
INTERIM HEALTHCARE OF DOWNSTATE ILLINOIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KYLE COLGAN RN (CLINICAL SUPERVISOR)
(309) 696-3822
Entity
Organization
Contact information
Practice address
1223 W PIONEER PKWY, PEORIA, IL 61615-1936
(309) 296-0056
Mailing address
1223 W PIONEER PKWY, PEORIA, IL 61615-1936
(309) 296-0056
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
01/11/2022
Last updated
01/11/2022
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