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Organization

CENTRAL ILLINOIS ARTHRITIS AND REHABILITATION CENTER PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DARYL KEITH MILLER M.D. (VICE-PRESIDENT)
(309) 353-5921
Entity
Organization

Contact information

Practice address
19 OLT AVE, PEKIN, IL 61554-6216
(309) 353-5921
(309) 353-6872
Mailing address
19 OLT AVE, PEKIN, IL 61554-6216
(309) 353-5921
(309) 353-6872

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
09032039
BLUE CROSS BLUE SHIELD
IL
01
DB6931
MEDICARE RAILROAD
IL
Enumeration date
03/29/2007
Last updated
07/21/2022
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