Central Illinois Preventive Services LLC
NPI #1144003633 in Bloomington, Illinois
Provider Information
- NPI Number
- 1144003633
- Entity Type
- Organization
- Organization Name
- Central Illinois Preventive Services LLC
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- CENTRAL ILLINOIS PREVENTIVE SERVICES LLC
- Primary Specialty
- Family Medicine
- Enumeration Date
- Aug 17, 2023
- Last Updated
- Aug 17, 2023
Practice Location
- Address
- 1603 TULLAMORE AVE STE A
- City
- Bloomington
- State
- Illinois
- ZIP Code
- 61704-9623
- Phone
- (309) 808-6407
Authorized Official
- Name
- LARRY OVERCASH, MD
- Title
- OWNER
- Phone
- (309) 696-9010
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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