| Activate Healthcare. | |
|
1524 W Glen Ave Peoria IL 61614-4692 | |
| (309) 512-0902 | |
| Not Available |
| Full Name | Activate Healthcare. |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1524 W Glen Ave, Peoria, Illinois |
| Authorized Official Name and Position | Jill Johnson Patton (DIRECTOR OF RISK MANAGEMENT) |
| Authorized Official Contact | 7049365546 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Activate Healthcare. 4651 Charlotte Park Dr Ste 300 Charlotte NC 28217-1916 Ph: () - | Activate Healthcare. 1524 W Glen Ave Peoria IL 61614-4692 Ph: (309) 512-0902 |
| NPI Number | 1922646686 |
|---|---|
| Provider Enumeration Date | 12/12/2019 |
| Last Update Date | 08/12/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922646686 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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