| Allergy And Asthma Carecenter Sc | |
|
120 Ne Glen Oak Ave Suite 408 Peoria IL 61603-4314 | |
| (309) 672-3158 | |
| (309) 672-3114 |
| Full Name | Allergy And Asthma Carecenter Sc |
|---|---|
| Speciality | Clinic/center |
| Location | 120 Ne Glen Oak Ave, Peoria, Illinois |
| Authorized Official Name and Position | Daniel W Palmer (PRESIDENT) |
| Authorized Official Contact | 3096723158 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Allergy And Asthma Carecenter Sc 120 Ne Glen Oak Ave Suite 408 Peoria IL 61603-4314 Ph: (309) 672-3158 | Allergy And Asthma Carecenter Sc 120 Ne Glen Oak Ave Suite 408 Peoria IL 61603-4314 Ph: (309) 672-3158 |
| NPI Number | 1225234206 |
|---|---|
| Provider Enumeration Date | 06/26/2007 |
| Last Update Date | 08/02/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225234206 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 042.007061036.047262 (Illinois) | Primary |
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