Organization
PREMIER MEDICAL GROUP, LLC
Active
Other names
OB/GYN Care Associates, SC
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN HESSE (EXECUTIVE ADMINISTRATOR)
(309) 662-6200
Entity
Organization
Contact information
Practice address
1505 EASTLAND DR STE 500, BLOOMINGTON, IL 61701-7905
(309) 662-2273
(309) 662-2014
Mailing address
1505 EASTLAND DR STE 500, BLOOMINGTON, IL 61701-7905
(309) 662-2273
(309) 662-2014
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
36-101512
IL
Other
Enumeration date
03/29/2011
Last updated
03/29/2011
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