Organization
PEORIA OBSTETRICS & GYNECOLOGY OF CENTRAL ILLINOIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA CLARK (ADMINISTRATOR)
(309) 687-4242
Entity
Organization
Contact information
Practice address
900 MAIN ST STE 660, PEORIA, IL 61602-1060
(309) 687-4230
(309) 687-4235
Mailing address
900 MAIN ST STE 660, PEORIA, IL 61602-1060
(309) 687-4230
(309) 687-4235
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
IL
Other
Enumeration date
11/15/2010
Last updated
11/15/2010
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