Surgical Associates of Bloomington, Ill,ltd

NPI #1447355383 in Bloomington, Illinois

Provider Information

NPI Number: 1447355383
Entity Type: Organization
Organization Name: Surgical Associates of Bloomington, Ill,ltd
Primary Specialty: Surgery
Enumeration Date: Sep 14, 2006
Last Updated: Feb 1, 2011

Practice Location

Address: 1404 EASTLAND DRIVE
Address 2: SUITE 104
City: Bloomington
State: Illinois
ZIP Code: 61701
Phone: (309) 663-4351

Authorized Official

Name: LAWRENCE A. RAINES, MD
Title: PRESIDENT
Phone: (309) 663-4351

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Surgery	208600000X	Primary

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