Healthcare Provider Details
I. General information
NPI: 1366358806
Provider Name (Legal Business Name): PRAIRIE VIEW SURGERY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
721 E COURT ST
PARIS IL
61944-2460
US
IV. Provider business mailing address
227 HOSPITAL LN
TERRE HAUTE IN
47802-4248
US
V. Phone/Fax
- Phone: 217-465-4141
- Fax: 217-465-5615
- Phone: 217-465-4141
- Fax: 217-465-5615
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA1903X |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MARTIN
ADAMS
Title or Position: VP OF FINANCE & CFO
Credential:
Phone: 217-822-3101