| Central Illinois Preventive Services Llc | |
|
2426 W Cornerstone Ct Ste 100 Peoria IL 61614-2400 | |
| (309) 966-3137 | |
| Not Available |
| Full Name | Central Illinois Preventive Services Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2426 W Cornerstone Ct Ste 100, Peoria, Illinois |
| Authorized Official Name and Position | Larry F Overcash (OWNER) |
| Authorized Official Contact | 3096969010 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Central Illinois Preventive Services Llc 400 Cimmeron Dr East Peoria IL 61611-7505 Ph: (309) 696-9010 | Central Illinois Preventive Services Llc 2426 W Cornerstone Ct Ste 100 Peoria IL 61614-2400 Ph: (309) 966-3137 |
| NPI Number | 1306349576 |
|---|---|
| Provider Enumeration Date | 03/14/2018 |
| Last Update Date | 03/14/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306349576 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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