Organization
PEORIA DAY SURGERY CENTER LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUSTIN R AHLMAN M.D. (CEO)
(309) 692-9210
Entity
Organization
Contact information
Practice address
7309 N KNOXVILLE AVE, PEORIA, IL 61614-2085
(309) 692-9210
(309) 683-4208
Mailing address
7309 N KNOXVILLE AVE, PEORIA, IL 61614-2085
(309) 692-9210
(309) 683-4208
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
7001449
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007001449
—
IL
Enumeration date
04/12/2006
Last updated
02/25/2019
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