| Tyrian Healthcare, Llc | |
|
2120 W Heading Ave West Peoria IL 61604-5138 | |
| (309) 306-1039 | |
| Not Available |
| Full Name | Tyrian Healthcare, Llc |
|---|---|
| Speciality | General Practice |
| Location | 2120 W Heading Ave, West Peoria, Illinois |
| Authorized Official Name and Position | Toufic S Khairallah (PRESIDENT & CEO/ NURSE PRACTITIONER) |
| Authorized Official Contact | 3093061039 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tyrian Healthcare, Llc Po Box 9183 Peoria IL 61612-9183 Ph: (309) 306-1039 | Tyrian Healthcare, Llc 2120 W Heading Ave West Peoria IL 61604-5138 Ph: (309) 306-1039 |
| NPI Number | 1447881487 |
|---|---|
| Provider Enumeration Date | 01/29/2020 |
| Last Update Date | 08/30/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447881487 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |