PEKIN PROHEALTH INC; NPI #1740433531

Contact Information

PEKIN PROHEALTH INC

19 OLT AVE
PEKIN, IL 61554-6216

Phone: 309-353-0902
Fax: 309-347-2623
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Radiology	261QR0200X	74	Radiation Therapy Center

Indicates primary specialty

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NPI Profile & details for PEKIN PROHEALTH INC

NPI # 1740433531

LBN Legal business name PEKIN PROHEALTH INC

Authorized official SHARON ADAMS - (VICE PRESIDENT)

Entity Organization

Organization subpart ¹ No

Enumeration date 10/24/2008

Last updated 12/30/2008 - About 17 years ago

Identifiers

IL	License #	009180787
IL	Medicaid	009180787
IL	Other	09015685	BCBS

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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