Organization
NEUROLOGICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD HENRY LEE MD (PRESIDENT)
(309) 692-1016
Entity
Organization
Contact information
Practice address
5401 N KNOXVILLE AVE, SUITE# 216, PEORIA, IL 61614-5098
(309) 692-1016
(309) 692-1044
Mailing address
5401 N.KNOXVILLE, PEORIA, IL 61614
(309) 692-1044
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036042577
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1366435158
NPI
IL
Enumeration date
05/03/2007
Last updated
06/20/2008
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