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PROCTOR HEALTH SYSTEMS NPI 1134173917


NPI Information

NPI: 1134173917
Provider Name: PROCTOR HEALTH SYSTEMS
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
5401 N KNOXVILLE AVE
SUITE 209
PEORIA, IL
ZIP 61614
Phone: (309) 689-6049
Get Directions

PROCTOR HEALTH SYSTEMS is a family medicine in Peoria, IL. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. PROCTOR HEALTH SYSTEMS NPI is 1134173917. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

5401 N KNOXVILLE AVE
SUITE 209
PEORIA, IL
ZIP 61614-098
Phone: (309) 689-6049
Fax: (309) 689-6092

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 11/1/2007.


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:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1367500000XNurse Anesthetist, Certified RegisteredNo
2207R00000XInternal MedicineNo
3208100000XPhysical Medicine & RehabilitationNo
4208200000XPlastic SurgeryNo
5207Q00000XFamily MedicineYes

Other Identifiers

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

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1242904MEDICARE ID-TYPE UNSPECIFIEDILLINOIS
2CD8123OTHERILLINOISRAILROAD MEDICARE
3CD8124OTHERILLINOISRAILROAD MEDICARE
4242900MEDICARE ID-TYPE UNSPECIFIEDILLINOIS
5242902MEDICARE ID-TYPE UNSPECIFIEDILLINOIS
6242903MEDICARE ID-TYPE UNSPECIFIEDILLINOIS
77232122OTHERILLINOISBC BS OF ILLINOIS
8242901MEDICARE ID-TYPE UNSPECIFIEDILLINOIS

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: 4/28/2024

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