PROCTOR HEALTH SYSTEMS NPI 1033163761

NPI Information

PROCTOR HEALTH SYSTEMS is a medical specialty clinic center in Peoria, IL. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). PROCTOR HEALTH SYSTEMS NPI is 1033163761. The provider is registered as an organization entity type.
The provider Is Doing Business As Illinois Valley Center For Plastic Surgery.

The provider's business location address is:

5401 N KNOXVILLE AVE
SUITE 103
PEORIA, IL
ZIP 61614-098
Phone: (309) 691-7800
Fax: (309) 691-7899

The provider's authorized official is Carrie Chiaravalle .
The authorized official title is Director and has the following contact phone number (309) 689-6049.

The enumeration date for this NPI number is 5/19/2006 and was last updated on 8/7/2007.

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:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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