CARDINAL MEDICAL GROUP LTD. NPI 1992829485

NPI Information

NPI: 1992829485
Provider Name: CARDINAL MEDICAL GROUP, LTD.
Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

Address:
6339 N BIG HOLLOW RD
PEORIA, IL
ZIP 61615
Phone: (309) 693-3315
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CARDINAL MEDICAL GROUP, LTD. is a multi-specialty clinic center in Peoria, IL. CARDINAL MEDICAL GROUP, LTD. NPI is 1992829485. The provider is registered as an organization entity type.

The provider's business location address is:

6339 N BIG HOLLOW RD
PEORIA, IL
ZIP 61615-907
Phone: (309) 693-3315
Fax: (309) 693-9385

The provider's authorized official is Michael A Shadley .
The authorized official title is Administrator and has the following contact phone number (309) 693-8611.

The enumeration date for this NPI number is 3/19/2007 and was last updated on 8/22/2020.

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	261QM1300X	Clinic/Center	Multi-Specialty		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: 4/28/2024

NPI Synchronization or Removal

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