Organization
EASTLAND MEDICAL PLAZA SURGICENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JACKIE ANN FRYE (BUSINESS OFFICE MANAGER)
(309) 663-1997
Entity
Organization
Contact information
Practice address
1505 EASTLAND DR, BLOOMINGTON, IL 61701-3534
(309) 663-1997
(309) 662-9527
Mailing address
1505 EASTLAND DR, BLOOMINGTON, IL 61701-3534
(309) 663-1997
(309) 662-9527
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
7002413
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7002413
STATE LICENSE
IL
Enumeration date
12/16/2005
Last updated
01/06/2010
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us