Individual
ALEXIS RENEE PRIDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5114 N GLEN PARK PLACE RD STE 110, PEORIA, IL 61614-4686
(309) 683-5600
(309) 683-5607
Mailing address
5114 N GLEN PARK PLACE RD STE 110, PEORIA, IL 61614-4686
(309) 683-5600
(309) 683-5607
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036172706
IL
208000000X
Pediatrics Physician
036172706
IL
208000000X
Pediatrics Physician
13452
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/13/2021
Last updated
01/07/2025
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