Organization
PEORIA UROLOGICAL ASSOCIATES S.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH BANNO M.D. (CEO)
(309) 692-9898
Entity
Organization
Contact information
Practice address
7309 N KNOXVILLE AVE, PEORIA, IL 61614-2085
(309) 692-9898
Mailing address
7309 N KNOXVILLE AVE, PEORIA, IL 61614-2085
(309) 692-9898
Taxonomy
Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
Primary
—
—
208800000X
Urology Physician
—
—
Other
Enumeration date
04/17/2006
Last updated
09/11/2025
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