Central Illinois Friends of Pwa, Inc.

NPI #1376492306 in Peoria, Illinois

Provider Information

NPI Number
1376492306
Entity Type
Organization
Organization Name
Central Illinois Friends of Pwa, Inc.
Primary Specialty
Nurse Practitioner - Community Health
Enumeration Date
Jan 23, 2026
Last Updated
Jan 23, 2026

Practice Location

Address
120 NE GLEN OAK AVE STE 201
City
Peoria
ZIP Code
61603-4315
Phone
(309) 431-5880

Authorized Official

Name
DERIC KIMLER
Title
EXECUTIVE DIRECTOR
Phone
(309) 431-5880

Specialties & Taxonomy Codes

Specialty
Clinic/Center - Community HealthCommunity Health
Nurse Practitioner - Community HealthCommunity Health

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