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NPI Profile for METHODIST MEDICAL CENTER OF ILLINOIS in PEORIA, IL.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
School |
363LS0200X | 50 | Nurse Practitioner |
| NPI Number | 1124305636 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 11/11/2011 | |
| Last updated | 02/14/2020 - About 6 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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METHODIST MEDICAL CENTER OF ILLINOIS
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METHODIST MEDICAL CENTER OF ILLINOIS