| Methodist Medical Center Of Illinois | |
|
221 Ne Glen Oak Ave Peoria IL 61636-0001 | |
| (309) 672-5522 | |
| (309) 671-2541 |
| Full Name | Methodist Medical Center Of Illinois |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 221 Ne Glen Oak Ave, Peoria, Illinois |
| Authorized Official Name and Position | Stephen M. Cirone (REGIONAL MGR-REIMB/REV RECOGNITION) |
| Authorized Official Contact | 3096724813 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Methodist Medical Center Of Illinois 221 Ne Glen Oak Ave Peoria IL 61636-0001 Ph: () - | Methodist Medical Center Of Illinois 221 Ne Glen Oak Ave Peoria IL 61636-0001 Ph: (309) 672-5522 |
| NPI Number | 1275583155 |
|---|---|
| Provider Enumeration Date | 05/11/2006 |
| Last Update Date | 02/14/2020 |
| Certification Date | 02/14/2020 |
| Medicare PECOS PAC ID | 1355259714 |
|---|---|
| Medicare Enrollment ID | O20080103000143 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275583155 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 0001594 (Illinois) | Primary |
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