Illinois Specialty Physician Services at Osf, LLC

NPI #1134352842 in Peoria, Illinois

Provider Information

NPI Number
1134352842
Entity Type
Organization
Organization Name
Illinois Specialty Physician Services at Osf, LLC
Subpart
Yes (part of a larger organization)
Parent Organization
OSF HEALTHCARE SYSTEM
Primary Specialty
Internal Medicine - Pulmonary Disease
Enumeration Date
Aug 27, 2009
Last Updated
Aug 28, 2009

Practice Location

Address
1001 MAIN ST
Address 2
STE 200
City
Peoria
ZIP Code
61606-1907
Phone
(309) 672-5682

Authorized Official

Name
JAMES M MOORE
Title
CEO
Phone
(309) 655-2880

Specialties & Taxonomy Codes

Specialty
Internal Medicine - Pulmonary DiseasePulmonary Disease

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