Premier Medical Group, LLC

NPI #1720377690 in Normal, Illinois

Provider Information

NPI Number: 1720377690
Entity Type: Organization
Organization Name: Premier Medical Group, LLC
Primary Specialty: Surgery
Enumeration Date: Mar 31, 2011
Last Updated: Mar 31, 2011

Practice Location

Address: 1537 FORT JESSE RD
Address 2: SUITE A
City: Normal
State: Illinois
ZIP Code: 61761-6192
Phone: (309) 808-0122

Authorized Official

Name: MR. JOHN HESSE
Title: EXECUTIVE ADMINISTRATOR
Phone: (309) 662-6200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Surgery	208600000X	Primary

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