| Bcbs Medicaid | |
|
8600 N State Route 91 Peoria IL 61615-9541 | |
| (309) 683-5050 | |
| Not Available |
| Full Name | Bcbs Medicaid |
|---|---|
| Speciality | Internal Medicine |
| Location | 8600 N State Route 91, Peoria, Illinois |
| Authorized Official Name and Position | Robert C Sehring (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 3096552850 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bcbs Medicaid 124 Sw Adams St Peoria IL 61602-1308 Ph: (309) 655-2850 | Bcbs Medicaid 8600 N State Route 91 Peoria IL 61615-9541 Ph: (309) 683-5050 |
| NPI Number | 1467041343 |
|---|---|
| Provider Enumeration Date | 01/14/2021 |
| Last Update Date | 03/07/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467041343 | NPI | - | NPPES |
| 000 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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