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HEARTLAND COMMUNITY HEALTH CLINIC NPI 1548201098

NPI Profile

NPI: 1548201098

Provider Name: HEARTLAND COMMUNITY HEALTH CLINIC

Doing Business As: HEARTLAND DENTAL CLINIC ALLIED

Classification: Clinic/Center - 261QD0000X

Entity Type: Organization

Specialization: Dental

Address:
2321 N WISCONSIN AVE
PEORIA, IL
ZIP 61603

Phone: (309) 680-7640

HEARTLAND COMMUNITY HEALTH CLINIC is a dental clinic/center in Peoria, IL. HEARTLAND COMMUNITY HEALTH CLINIC NPI is 1548201098. The provider is registered as an organization entity type.
The provider Is Doing Business As Heartland Dental Clinic Allied.

The provider's business location address is:

2321 N WISCONSIN AVE
PEORIA, IL
ZIP 61603-613
Phone: (309) 680-7640
Fax: (309) 681-8601

The provider's authorized official is Farrell K Davies .
The authorized official title is Ceo and has the following contact phone number (309) 680-7657.

The enumeration date for this NPI number is 6/8/2006 and was last updated on 3/9/2010.

Map - Location of Practice

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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 261QD0000X Clinic/Center Dental Yes

What is NPI?
NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 8/11/2015