BOCHANTIN OBSTETRICS & GYNECOLOGY SERVICES LTD NPI 1811016702

NPI Information

NPI: 1811016702
Provider Name: BOCHANTIN OBSTETRICS & GYNECOLOGY SERVICES LTD
Classification: Obstetrics & Gynecology - 207V00000X
Entity Type: Organization

CLIA Number: 14D1012248

Address:
5401 N KNOXVILLE AVE
SUITE 308
PEORIA, IL
ZIP 61614
Phone: (309) 692-5100
Get Directions

BOCHANTIN OBSTETRICS & GYNECOLOGY SERVICES LTD is an obstetrics gynecology in Peoria, IL. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. BOCHANTIN OBSTETRICS & GYNECOLOGY SERVICES LTD NPI is 1811016702. 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 308
PEORIA, IL
ZIP 61614-098
Phone: (309) 692-5100
Fax: (309) 692-1400

The provider's authorized official is Marla Tomlinson .
The authorized official title is Office Manager and has the following contact phone number (309) 692-5100.

The CLIA number assigned to this NPI record is 14D1012248 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 3/29/2007 and was last updated on 9/7/2011.

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	207V00000X	Obstetrics & Gynecology		036098292	ILLINOIS	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	036098292	MEDICAID	ILLINOIS
2	09032023	OTHER	ILLINOIS	BLUECROSS BLUESHIELD
3	H14498	MEDICARE UPIN
4	211927	MEDICARE PIN	ILLINOIS
5	447752	OTHER	ILLINOIS	HEALTHLINK

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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