Central Illinois Center for Wellness, LLC
NPI #1104391739 in Bloomington, Illinois
Provider Information
- NPI Number
- 1104391739
- Entity Type
- Organization
- Organization Name
- Central Illinois Center for Wellness, LLC
- Primary Specialty
- Clinic/Center - Primary Care
- Enumeration Date
- Oct 10, 2018
- Last Updated
- Aug 1, 2024
Practice Location
- Address
- 2501 E COLLEGE AVE STE C
- City
- Bloomington
- State
- Illinois
- ZIP Code
- 61704-2484
- Phone
- (309) 807-5356
Authorized Official
- Name
- WILLIAM JOHN RAY, MD
- Title
- PHYSICIAN/OWNER
- Phone
- (309) 807-5356
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Primary Care — Primary Care |
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