Organization
CENTRAL ILLINOIS RADIOLOGICAL ASSOCIATES, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH FRASER M.D. (PRESIDENT)
(309) 494-9320
Entity
Organization
Contact information
Practice address
OSF ST FRANCIS MEDICAL CTR, 530 N.E. GLEN OAK, PEORIA, IL 61636-0001
(309) 655-4934
Mailing address
411 HAMILTON BLVD, SUITE 1824, PEORIA, IL 61602-1144
(309) 494-9320
(309) 494-9321
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
07/29/2006
Last updated
08/22/2020
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