| Residency Training Clinic | |
|
1800 N Knoxville Ave Ste A Peoria IL 61603-3005 | |
| (309) 680-7600 | |
| (309) 495-8614 |
| Full Name | Residency Training Clinic |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 1800 N Knoxville Ave Ste A, Peoria, Illinois |
| Authorized Official Name and Position | Sharon A Adams (CEO) |
| Authorized Official Contact | 3096807665 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Residency Training Clinic 2214 N University St Peoria IL 61604-3221 Ph: (309) 680-7600 | Residency Training Clinic 1800 N Knoxville Ave Ste A Peoria IL 61603-3005 Ph: (309) 680-7600 |
| NPI Number | 1568883718 |
|---|---|
| Provider Enumeration Date | 12/13/2013 |
| Last Update Date | 03/12/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568883718 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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