Organization
PRAIRIE EMERGENCY GROUP, LTD.
Active
Organization
PRAIRIE EMERGENCY GROUP, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL J STRAZA (OPERATIONS MANAGER)
(309) 661-2247
Entity
Organization
Contact information
Practice address
VIRGINIA & FRANKLIN STREETS, NORMAL, IL 61761
(309) 827-4321
Mailing address
1 JODI LN, BLOOMINGTON, IL 61701-2012
(309) 661-2247
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05721369
BC/BS OF ILLINOIS
IL
Enumeration date
07/13/2006
Last updated
10/22/2007
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