Peoria Obstetrics & Gynecology, S.c.

NPI #1477672020 in Peoria, Illinois

Provider Information

NPI Number: 1477672020
Entity Type: Organization
Organization Name: Peoria Obstetrics & Gynecology, S.c.
Primary Specialty: Obstetrics & Gynecology
Enumeration Date: Mar 28, 2007
Last Updated: Jan 26, 2009

Practice Location

Address: 900 MAIN ST STE 660
City: Peoria
State: Illinois
ZIP Code: 61602-1060
Phone: (309) 687-4230

Authorized Official

Name: MRS. PAULA M CLARK
Title: PRACTICE ADMINISTRATOR
Phone: (309) 687-4242

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Obstetrics & Gynecology	207V00000X	Primary

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