Allergy & Asthma of Illinois Sc

NPI #1194712547 in Peoria, Illinois

Provider Information

NPI Number: 1194712547
Entity Type: Organization
Organization Name: Allergy & Asthma of Illinois Sc
Primary Specialty: Allergy & Immunology
Enumeration Date: Sep 30, 2005
Last Updated: Jan 26, 2010

Practice Location

Address: 6615 N BIG HOLLOW RD
City: Peoria
State: Illinois
ZIP Code: 61615-2450
Phone: (309) 691-5200

Authorized Official

Name: DR. STEPHEN J SMART, MD
Title: PRESIDENT
Phone: (309) 691-5200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Allergy & Immunology	207K00000X	Primary

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