Individual
SALLY WINEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
507 E ARMSTRONG AVE, REGIONAL DEVELOPMENT CENTER, PEORIA, IL 61603-3201
(309) 681-6960
Mailing address
1 ILLINI DR, PEORIA, IL 61605-2576
(309) 671-8503
Taxonomy
Speciality
Code
Description
License number
State
2080P0008X
Pediatric Neurodevelopmental Disabilities Physician
Primary
036077743
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0360777432
—
IL
01
—
07215036
BCBS
IL
01
—
IL01AE
JOHN DEERE
IL
Enumeration date
03/15/2006
Last updated
01/30/2014
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