Organization
PREMIER MEDICAL GROUP, LLC
Active
Other names
Mid-Central Illinois Gastroenterology, Ltd.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN HESSE (EXECUTIVE ADMINISTRATOR)
(309) 662-6200
Entity
Organization
Contact information
Practice address
2200 JACOBSSEN DR, SUITE B, NORMAL, IL 61761-5516
(309) 451-1123
(309) 451-1212
Mailing address
2200 JACOBSSEN DR, SUITE B, NORMAL, IL 61761-5516
(309) 451-1123
(309) 451-1212
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
IL
Other
Enumeration date
03/21/2011
Last updated
03/21/2011
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