Medical Service Plan At Peoria

LBN: University Of Illinois
Medical Service Plan At Peoria is an health care organization with primary practice located at 515 Ne Glen Oak Ave Pediatric Neurology, Peoria IL 61603-3165. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Neurodevelopmental Disabilities, which is considered as the primary health care specialty. University Of Illinois can be contacted via phone (309) 624-9844, or through Nicholas, William R via phone (312) 413-0573.

Contact Information

Primary practice address
515 Ne Glen Oak Ave Pediatric Neurology Peoria IL 61603-3165
Phone: (309) 624-9844
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Nicholas, William R PHD
Phone: (312) 413-0573

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurodevelopmental Disabilities 2080P0008X Illinois

Profile Details

NPI number 1174596225
LBN Legal business name University Of Illinois
DBA Doing business as Medical Service Plan At Peoria
Authorized official Nicholas, William R PHD
Entity Organization
Organization subpart 1 No
Enumeration date Feb 9th, 2006
Last updated Aug 22nd, 2020 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174596225 NPPES
Illinois Other 07215036 BCBS

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