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2500 W Reynolds St Pontiac IL 61764-9774 | |
| (800) 589-6070 | |
| (309) 683-5969 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 2500 W Reynolds St, Pontiac, Illinois |
| Authorized Official Name and Position | Robert C Sehring (CEO) |
| Authorized Official Contact | 3096552850 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
124 Sw Adams St Peoria IL 61602-1308 Ph: (309) 655-2850 | 2500 W Reynolds St Pontiac IL 61764-9774 Ph: (800) 589-6070 |
| NPI Number | 1699722983 |
|---|---|
| Provider Enumeration Date | 05/30/2006 |
| Last Update Date | 07/31/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699722983 | NPI | - | NPPES |
| 5323453 | Other | IL | BLUE SHIELD |
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