Organization
MUSCULOSKELETAL SURGICAL CENTER
Active
Other names
Orthopedic Institute ASC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD E. PALMER M.D. (PRESIDENT)
(309) 676-5546
Entity
Organization
Contact information
Practice address
303 N WILLIAM KUMPF BLVD, PEORIA, IL 61605-2507
(309) 676-5546
(309) 676-5045
Mailing address
303 N WILLIAM KUMPF BLVD, PEORIA, IL 61605-2507
(309) 676-5546
(309) 676-5045
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7001563
DEPARTMENT OF PUBLIC HEAL
IL
Enumeration date
04/06/2006
Last updated
08/22/2020
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