South Side Office of Concern

NPI #1174724280 in Peoria, Illinois

Provider Information

NPI Number: 1174724280
Entity Type: Organization
Organization Name: South Side Office of Concern
Primary Specialty: Case Management
Enumeration Date: May 29, 2007
Last Updated: Apr 23, 2008

Practice Location

Address: 1316 SW ADAMS ST
City: Peoria
State: Illinois
ZIP Code: 61602-1702
Phone: (309) 674-7310

Authorized Official

Name: MRS. CHRISTINE E KAHL, CADC
Title: EXECUTIVE DIRECTOR
Phone: (309) 674-7310

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Case Management	251B00000X	Primary

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