Phillip A. Immesoete Md, Ltd

LBN: Phillip A. Immesoete Md, Ltd
Phillip A. Immesoete Md, Ltd is an health care organization with primary practice located at 5401 N Knoxville Ave Suite 406, Peoria IL 61614-5098. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility, which is considered as the primary health care specialty. Phillip A. Immesoete Md, Ltd can be contacted via phone (309) 691-0030, or through Immesoete, Phillip Arthur via phone (309) 691-0030.

Contact Information

Primary practice address
5401 N Knoxville Ave Suite 406 Peoria IL 61614-5098
Phone: (309) 691-0030
Fax: (309) 691-9262
Website:
Map and Directions
Authorized official contact:
Name: Immesoete, Phillip Arthur Doctor of Medicine (MD)
Phone: (309) 691-0030

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility 313M00000X 036042568 Illinois

Profile Details

NPI number 1245544543
LBN Legal business name Phillip A. Immesoete Md, Ltd
DBA Doing business as
Authorized official Immesoete, Phillip Arthur Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 29th, 2010
Last updated Jul 29th, 2010 - about 14 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 1245544543 NPPES
Illinois MEDICAID 036042568

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