Organization
METHODIST MEDICAL CENTER OF ILLINOIS
Active
Other names
MMG In School Health Trewyn
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN M CIRONE (REGIONAL MGR-REIMB/REV RECOGNITION)
(309) 672-4813
Entity
Organization
Contact information
Practice address
1419 S FOLKERS AVE, PEORIA, IL 61605
(309) 685-8390
Mailing address
5100 RELIABLE PKWY, CHICAGO, IL 60686-0051
Taxonomy
Speciality
Code
Description
License number
State
363LS0200X
School Nurse Practitioner
Primary
—
—
Other
Enumeration date
11/14/2011
Last updated
02/14/2020
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