Peoria Obstetrics & Gynecology of Central Illinois

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

PEORIA OBSTETRICS & GYNECOLOGY OF CENTRAL ILLINOIS

Practice address

900 Main St Ste 660
Peoria, IL 61602-1060

Phone

(309) 687-4230

Fax

(309) 687-4235

NPI assigned

Nov 15, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Paula Clark

Title

Administrator

Phone

(309) 687-4242

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1289779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289779200000",
    "number": "1659672129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 MAIN ST STE 660",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616021060",
            "telephone_number": "309-687-4230",
            "fax_number": "309-687-4235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 MAIN ST STE 660",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616021060",
            "telephone_number": "309-687-4230",
            "fax_number": "309-687-4235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEORIA OBSTETRICS & GYNECOLOGY OF CENTRAL ILLINOIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-15",
        "last_updated": "2010-11-15",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "PAULA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "309-687-4242"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peoria Hospital'S Mobile Medical Services
• Peoria Integrative Medical Center LTD
• Peoria Midwest Equpiment Inc
• Peoria NH LLC
• Peoria Non- Emergency Medical Transport
• Peoria Obstetrics & Gynecology, S.C.
• Peoria Podiatry Group PC
• Peoria Psychological Associates, P.C.
• Peoria Pulmonary Associates, LTD.
• Peoria School Dist 150

• Obstetrics & Gynecology Physician in Peoria, IL
• Providers in Peoria, IL by specialty
• Obstetrics & Gynecology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.