| |
8309 N Knoxville Ave, Peoria, IL 61615-2170 | |
(309) 713-3664 | |
(309) 839-0078 |
Full Name | |
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Type | Facility |
Speciality | Durable Medical Equipment & Medical Supplies |
Location | 8309 N Knoxville Ave, Peoria, Illinois |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1629319330 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 046010457 (Illinois) | Secondary |
332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
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8309 N Knoxville Ave, Peoria, IL 61615-2170 Ph: (309) 693-9540 | 8309 N Knoxville Ave, Peoria, IL 61615-2170 Ph: (309) 713-3664 |