INTEGRAMED MEDICAL ILLINOIS LLC NPI 1396169280

NPI Information

NPI: 1396169280
Provider Name: INTEGRAMED MEDICAL ILLINOIS, LLC
Classification: Obstetrics & Gynecology - 207VE0102X
Entity Type: Organization

Specialization: Reproductive Endocrinology

Address:
5401 N KNOXVILLE AVE
SUITE 102
PEORIA, IL
ZIP 61614
Phone: (309) 689-0411
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INTEGRAMED MEDICAL ILLINOIS, LLC is a reproductive endocrinology obstetrics gynecology in Peoria, IL. The provider is an obstetrician/gynecologist who is capable of managing complex problems relating to reproductive endocrinology and infertility. INTEGRAMED MEDICAL ILLINOIS, LLC NPI is 1396169280. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5401 N KNOXVILLE AVE
SUITE 102
PEORIA, IL
ZIP 61614-098
Phone: (309) 689-0411

The provider's authorized official is Satish Vayuvegula .
The authorized official title is Presiden And Secretary and has the following contact phone number (309) 689-0411.

The enumeration date for this NPI number is 2/12/2014 and was last updated on 2/24/2014.

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	207VE0102X	Obstetrics & Gynecology	Reproductive Endocrinology		ILLINOIS	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: 11/14/2023

NPI Synchronization or Removal

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