Organization
NEUROLOGY CLINIC OF PEORIA SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GENE C CHENG MD (DIRECTOR)
(309) 692-9516
Entity
Organization
Contact information
Practice address
5401 N KNOXVILLE AVE, SUITE 414, PEORIA, IL 61614-5098
(309) 692-9516
(309) 692-9530
Mailing address
5401 N KNOXVILLE AVE, SUITE 414, PEORIA, IL 61614-5098
(309) 692-9516
(309) 692-9530
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
042617586
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036088131
—
IL
Enumeration date
01/31/2007
Last updated
05/26/2009
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