PROCTOR HEALTH SYSTEMS NPI 1396923702

NPI Information

PROCTOR HEALTH SYSTEMS is a clinic center in Peoria, IL. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). PROCTOR HEALTH SYSTEMS NPI is 1396923702. The provider is registered as an organization entity type.
The provider Is Doing Business As Proctor Medical Group Renaldo Jacques Md.

The provider's business location address is:

5401 N KNOXVILLE AVE STE 306
PEORIA, IL
ZIP 61614-021
Phone: (309) 691-0027

The provider's authorized official is Carrie Chiaravalle .
The authorized official title is Director Operations and has the following contact phone number (309) 689-6043.

The enumeration date for this NPI number is 2/7/2008 and was last updated on 2/7/2008.

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

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