Organization
PEORIA EAR NOSE AND THROAT GROUP SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYLER ROBERTSON (CEO)
(309) 202-0462
Entity
Organization
Contact information
Practice address
7301 N KNOXVILLE AVE, PEORIA, IL 61614-2017
(309) 589-5900
(309) 689-0312
Mailing address
7301 N KNOXVILLE AVE, PEORIA, IL 61614-2017
(309) 589-5900
(309) 683-4120
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
042000742
IL
Other
Enumeration date
01/11/2006
Last updated
07/22/2025
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