Medical Service Plan @ Peoria

LBN: University Of Illinois
Medical Service Plan @ Peoria is an health care organization with primary practice located at 530 Ne Glen Oak Ave Dept Of Internal Medicine, Peoria IL 61637-0001. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as the primary health care specialty. University Of Illinois can be contacted via phone (309) 655-3292, or through Nicholas, William R via phone (312) 413-0573.

Contact Information

Primary practice address
530 Ne Glen Oak Ave Dept Of Internal Medicine Peoria IL 61637-0001
Phone: (309) 655-3292
Fax: (309) 655-7732
Website:
Map and Directions
Authorized official contact:
Name: Nicholas, William R PHD
Phone: (312) 413-0573

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X

Profile Details

NPI number 1255301909
LBN Legal business name University Of Illinois
DBA Doing business as Medical Service Plan @ Peoria
Authorized official Nicholas, William R PHD
Entity Organization
Organization subpart 1 No
Enumeration date Jan 25th, 2006
Last updated Aug 22nd, 2020 - about 4 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 1255301909 NPPES
Illinois Other 07215036 BCBS

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