Peoria Integrative Medical Center Ltd in Peoria - Family Medicine

Peoria Integrative Medical Center Ltd - NPI 1699839985

Peoria Integrative Medical Center Ltd is a Family Medicine in Peoria, Illinois. Peoria Integrative Medical Center Ltd practices all healthcare services and medical treatments related to Family Medicine. The NPI Number for Peoria Integrative Medical Center Ltd is 1699839985. The last update date is 2009-04-20.

Peoria Integrative Medical Center Ltd's current location address is 4930 N Executive Dr, Peoria, Illinois. You can contact this provider via phone number 3096836002 and fax number 3096836007. The mailing address for Peoria Integrative Medical Center Ltd is 4930 N Executive Dr, Peoria, Illinois. To know further, please read the information below!

Provider Profile Detail

Provider Organization Peoria Integrative Medical Center Ltd
Address 4930 N Executive Dr, Peoria, Illinois
Phone Number 3096836002
Fax Number 3096836007
Sole Proprietor --
Credentials --

Authorized Official

Title or Position OWNER
Authorized Official Name Xie Yang
Credentials M.D.
Telephone Number 3096367302

NPI Number Detail

NPI Number 1699839985
Provider Enumeration Date 2006-12-20
Last Updated Date 2009-04-20

Provider Mailing Address Detail

Address 4930 N Executive Dr
City Peoria
State Illinois (IL)
Post Code 616144894
Phone Number 3096836002
Fax Number 3096836007

Provider's Primary Taxonomy Detail

Speciality Family Medicine
Taxonomy 207Q00000X
Licence No 36114042
Definition:
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine i

Provider's Other Legacy Identifiers

Identifier Identifier Type Identifier State Identifier Issuer
36114042 IL --

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FAQs about Peoria Integrative Medical Center Ltd

What is the unique provider identifier assigned to Peoria Integrative Medical Center Ltd?

The Peoria Integrative Medical Center Ltd has been issued the NPI (National Provider Identifier) 1699839985 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.

Could you please share the complete physical address where Peoria Integrative Medical Center Ltd is geographically located?

The Peoria Integrative Medical Center Ltd is physically situated at the following location: 4930 N Executive Dr, Peoria, IL, 616144894.

What is the Peoria Integrative Medical Center Ltd's specialty and taxonomy code?

The Peoria Integrative Medical Center Ltd's specialty is Family Medicine, and the corresponding taxonomy code is 207Q00000X.

On what date did the Centers for Medicare & Medicaid Services issue the 1699839985 to Peoria Integrative Medical Center Ltd?

The Peoria Integrative Medical Center Ltd received its 1699839985 assignment from the Centers for Medicare & Medicaid Services on 2006-12-20.

As of what date was the information regarding Peoria Integrative Medical Center Ltd, such as address, specialty, and other details, last verified and confirmed to be up-to-date?

The information related to Peoria Integrative Medical Center Ltd, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2009-04-20.

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