HEARTLAND COMMUNITY HEALTH CLINIC NPI 1336193861

NPI Information

HEARTLAND COMMUNITY HEALTH CLINIC is a federally qualified health center (fqhc) clinic center in Peoria, IL. HEARTLAND COMMUNITY HEALTH CLINIC NPI is 1336193861. The provider is registered as an organization entity type.
The provider Is Doing Business As Heartland Health Services-garden.

The provider's business location address is:

1701 W GARDEN ST
PEORIA, IL
ZIP 61605-531
Phone: (309) 680-7600
Fax: (309) 680-7686

The provider's authorized official is Sharon A Adams .
The authorized official title is Ceo and has the following contact phone number (309) 680-7665.

The CLIA number assigned to this NPI record is 14D2115339 - federally qualified health center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 5/20/2006 and was last updated on 3/12/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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