| Thomas F Kouri Internal Medicine Inc | |
|
5401 N Knoxville Ave Peoria IL 61614-5098 | |
| (309) 689-9088 | |
| (309) 689-9072 |
| Full Name | Thomas F Kouri Internal Medicine Inc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 5401 N Knoxville Ave, Peoria, Illinois |
| Authorized Official Name and Position | Thomas Kouri (MEDICAL DOCTOR) |
| Authorized Official Contact | 3096899088 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Thomas F Kouri Internal Medicine Inc 5401 N Knoxville Ave Suite 212 Peoria IL 61614-5098 Ph: (309) 689-6049 | Thomas F Kouri Internal Medicine Inc 5401 N Knoxville Ave Peoria IL 61614-5098 Ph: (309) 689-9088 |
| NPI Number | 1194825190 |
|---|---|
| Provider Enumeration Date | 09/22/2006 |
| Last Update Date | 06/11/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194825190 | NPI | - | NPPES |
| 036071029 | Medicaid | IL | |
| 07228117 | Other | IL | BCBSIL |
| CK6092 | Other | IL | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 036071029 (Illinois) | Primary |
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