Proctor Health Systems

NPI #1134173917 in Peoria, Illinois

Provider Information

NPI Number: 1134173917
Entity Type: Organization
Organization Name: Proctor Health Systems
Primary Specialty: Family Medicine
Enumeration Date: May 19, 2006
Last Updated: Nov 1, 2007

Practice Location

Address: 5401 N KNOXVILLE AVE
Address 2: SUITE 209
City: Peoria
State: Illinois
ZIP Code: 61614-5098
Phone: (309) 689-6049

Authorized Official

Name: CARRIE CHIARAVALLE
Title: DIRECTOR
Phone: (309) 689-6049

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X
Physical Medicine & Rehabilitation	208100000X
Plastic Surgery	208200000X
Nurse Anesthetist, Certified Registered	367500000X
Family Medicine	207Q00000X	Primary

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