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Contact Information

DENTAL PROFESSIONALS OF ILLINOIS, P.C.
6808 N. KNOXVILLE AVENUE
PEORIA, IL61614
 Phone: 309-691-8558
 Fax: 309-691-8598
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for DENTAL PROFESSIONALS OF ILLINOIS, P.C.

NPI # 1225250590
LBN Legal business name DENTAL PROFESSIONALS OF ILLINOIS, P.C.
Authorized official LINDSAY BEARDEN - (INS COOD)
Entity Organization
Organization subpart 1 Yes
Enumeration date 05/03/2007
Last updated 01/08/2014 - About 12 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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