University of Illinois

NPI #1861472151 in Peoria, Illinois

Provider Information

NPI Number: 1861472151
Entity Type: Organization
Organization Name: University of Illinois
Primary Specialty: Pediatrics
Enumeration Date: Jan 20, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 320 E ARMSTRONG AVE
City: Peoria
State: Illinois
ZIP Code: 61603-3172
Phone: (309) 624-9680

Authorized Official

Name: DR. WILLIAM R NICHOLAS, PHD
Title: EXECUTIVE DIRECTOR MEDICAL SERVICE
Phone: (312) 413-0573

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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