Tyrian Healthcare, Llc | |
2120 W Heading Ave West Peoria IL 61604-5138 | |
(309) 306-1039 | |
Not Available |
Full Name | Tyrian Healthcare, Llc |
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Speciality | General Practice |
Location | 2120 W Heading Ave, West Peoria, Illinois |
Authorized Official Name and Position | Toufic S Khairallah (PRESIDENT & CEO/ NURSE PRACTITIONER) |
Authorized Official Contact | 3093061039 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Tyrian Healthcare, Llc Po Box 9183 Peoria IL 61612-9183 Ph: (309) 306-1039 | Tyrian Healthcare, Llc 2120 W Heading Ave West Peoria IL 61604-5138 Ph: (309) 306-1039 |
NPI Number | 1447881487 |
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Provider Enumeration Date | 01/29/2020 |
Last Update Date | 08/30/2021 |
Identifier | Type | State | Issuer |
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1447881487 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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208D00000X | General Practice | (* (Not Available)) | Primary |