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Contact Information

ILLINOIS VALLEY ENDODONTICS LLC
1601 4TH ST
PERU, IL61354-3507
 Phone: 815-224-3636
 Fax: 815-220-1479
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Endodontics

1223E0200X
Indicates primary specialty

NPI Profile & details for ILLINOIS VALLEY ENDODONTICS LLC

NPI Number 1407031305
LBN Legal business name ILLINOIS VALLEY ENDODONTICS LLC
Authorized official LEE CERESA - (OWNER/DENTIST)
Entity Organization
Organization subpart 1 No
Enumeration date 01/09/2008
Last updated 01/09/2008 - About 18 years ago
Identifiers n/a
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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