Organization
PRAIRIE SURGICARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD KUBE II MD, FACSS (OWNER/MEDICAL DIRECTOR)
(309) 691-7774
Entity
Organization
Contact information
Practice address
7620 N UNIVERSITY ST, SUITE 101, PEORIA, IL 61614-8300
(309) 691-7774
(309) 689-5768
Mailing address
7620 N UNIVERSITY ST, SUITE 101, PEORIA, IL 61614-8300
(309) 691-7774
(309) 689-5768
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
05/15/2012
Last updated
05/15/2012
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