Organization
WOMEN'S HEALTH INSTITUTE LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARRY F OVERCASH M.D. (OWNER)
(309) 671-5100
Entity
Organization
Contact information
Practice address
7309 N KNOXVILLE AVE, SUITE 300, PEORIA, IL 61614-2085
(309) 671-5100
(309) 671-5155
Mailing address
7309 N KNOXVILLE AVE, SUITE 300, PEORIA, IL 61614-2085
(309) 671-5100
(309) 671-5155
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036.072608
—
IL
05
—
036.108543
—
IL
01
—
7215145
BLUECROSS BLUESHIELD
IL
Enumeration date
07/19/2006
Last updated
04/12/2019
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