Organization
METHODIST MEDICAL CENTER OF ILLINOIS
Active
Parent organization
METHODIST MEDICAL CENTER OF ILLINOIS
Organization subpart
Yes
Provider details
NPI number
Legal business name
METHODIST MEDICAL CENTER OF ILLINOIS
Authorized official
STEPHEN M. CIRONE (REGIONAL MGR-REIMB/REV RECOGNITION)
(309) 672-4813
Entity
Organization
Contact information
Practice address
221 NE GLEN OAK AVE, PEORIA, IL 61636-0001
(309) 672-5522
Mailing address
221 NE GLEN OAK AVE, PEORIA, IL 61636-0001
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
0001594
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
116
BLUE CROSS NUMBER
IL
Enumeration date
05/16/2006
Last updated
02/14/2020
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