PROCTOR HEALTH SYSTEMS NPI 1720223837

NPI Information

NPI: 1720223837
Provider Name: PROCTOR HEALTH SYSTEMS

Doing Business As: PROCTOR MEDICAL GROUP SURGERY - C K SONG MD

Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
5401 N KNOXVILLE AVE
STE 217
PEORIA, IL
ZIP 61614
Phone: (309) 691-1092
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PROCTOR HEALTH SYSTEMS is an ambulatory surgical clinic center in Peoria, IL. PROCTOR HEALTH SYSTEMS NPI is 1720223837. The provider is registered as an organization entity type.
The provider Is Doing Business As Proctor Medical Group Surgery - C K Song Md.

The provider's business location address is:

5401 N KNOXVILLE AVE
STE 217
PEORIA, IL
ZIP 61614-098
Phone: (309) 691-1092

The provider's authorized official is Denise Brinker .
The authorized official title is System Analyst and has the following contact phone number (390) 689-6089.

The enumeration date for this NPI number is 12/4/2008 and was last updated on 12/4/2008.

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical			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: 4/28/2024

NPI Synchronization or Removal

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