Organization
PSYCHOLOGICAL ASSOCIATES PROFESSIONALS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONALD R LEGAN ED D (CLINICAL PSYCHOLOGIST)
(309) 691-0420
Entity
Organization
Contact information
Practice address
5409 N KNOXVILLE AVE, PEORIA, IL 61614
(309) 691-0420
(309) 691-0520
Mailing address
5409 N KNOXVILLE AVE, PEORIA, IL 61614
(309) 691-0420
(309) 691-0520
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
71002085
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07220997
BCBS
—
01
—
L015956
CHAMPUS
—
Enumeration date
03/07/2006
Last updated
08/17/2017
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