Organization
PROCTOR HEALTH SYSTEMS
Active
Parent organization
PROCTOR HEALTH SYSTEMS
Other names
PROCTOR MEDICAL GROUP SURGERY - C K SONG MD
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROCTOR HEALTH SYSTEMS
Authorized official
DENISE BRINKER (SYSTEM ANALYST)
(390) 689-6089
Entity
Organization
Contact information
Practice address
5401 N KNOXVILLE AVE, STE 217, PEORIA, IL 61614-5098
(309) 691-1092
Mailing address
5401 N KNOXVILLE AVE, STE 209, PEORIA, IL 61614-5098
(309) 691-1092
(309) 689-6092
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
12/04/2008
Last updated
12/04/2008
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