Organization
THOMAS F KOURI INTERNAL MEDICINE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS KOURI MD (MEDICAL DOCTOR)
(309) 689-9088
Entity
Organization
Contact information
Practice address
5401 N KNOXVILLE AVE, PEORIA, IL 61614-5098
(309) 689-9088
(309) 689-9072
Mailing address
5401 N KNOXVILLE AVE, SUITE 212, PEORIA, IL 61614-5098
(309) 689-6049
(309) 689-6092
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
036071029
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036071029
—
IL
01
—
07228117
BCBSIL
IL
01
—
CK6092
RAILROAD MEDICARE
IL
Enumeration date
09/22/2006
Last updated
06/11/2013
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