Organization
CENTRAL ILLINOIS PREVENTIVE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY F OVERCASH MD (OWNER)
(309) 696-9010
Entity
Organization
Contact information
Practice address
2426 W CORNERSTONE CT STE 100, PEORIA, IL 61614-2400
(309) 966-3137
Mailing address
400 CIMMERON DR, EAST PEORIA, IL 61611-7505
(309) 696-9010
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
03/14/2018
Last updated
01/24/2025
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