| Eagle Family Medicine Sc | |
|
2809 W Willow Knolls Suite C Peoria IL 61614-8259 | |
| (309) 692-6604 | |
| (309) 692-6492 |
| Full Name | Eagle Family Medicine Sc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 2809 W Willow Knolls Suite C, Peoria, Illinois |
| Authorized Official Name and Position | Robert Scott Bevill (PHYSICIAN PRESIDENT) |
| Authorized Official Contact | 3096926604 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eagle Family Medicine Sc 2809 W Willow Knolls Suite C Peoria IL 61614-8259 Ph: (309) 692-6604 | Eagle Family Medicine Sc 2809 W Willow Knolls Suite C Peoria IL 61614-8259 Ph: (309) 692-6604 |
| NPI Number | 1659409290 |
|---|---|
| Provider Enumeration Date | 03/02/2007 |
| Last Update Date | 07/10/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659409290 | NPI | - | NPPES |
| 208745 | Other | IL | MEDICARE GROUP NUMBER |
| K37812 | Other | IL | MEDICARE PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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