| Planned Parenthood Of Illinois | |
|
705 Ne Jefferson St. Peoria IL 61603-3843 | |
| (309) 673-6911 | |
| (309) 673-6914 |
| Full Name | Planned Parenthood Of Illinois |
|---|---|
| Speciality | Clinic/center |
| Location | 705 Ne Jefferson St., Peoria, Illinois |
| Authorized Official Name and Position | Erika R Gonzalez (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 3125926892 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Planned Parenthood Of Illinois 17 N State St Ste 500 Chicago IL 60602-3384 Ph: (312) 592-6800 | Planned Parenthood Of Illinois 705 Ne Jefferson St. Peoria IL 61603-3843 Ph: (309) 673-6911 |
| NPI Number | 1083020911 |
|---|---|
| Provider Enumeration Date | 07/11/2014 |
| Last Update Date | 10/17/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083020911 | NPI | - | NPPES |
| 36170901001 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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