Healthcare Provider Details

I. General information

NPI: 1346656279
Provider Name (Legal Business Name): PLANNED PARENTHOOD OF ILLINOIS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2014
Last Update Date: 07/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

328 S 4TH STREET
PEKIN IL
61554-6804
US

IV. Provider business mailing address

18 S. MICHIGAN AVE 6TH FLOOR
CHICAGO IL
60603
US

V. Phone/Fax

Practice location:
  • Phone: 309-347-1274
  • Fax: 309-347-6283
Mailing address:
  • Phone: 312-592-6800
  • Fax: 312-592-6801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. ANTHONY FIORE
Title or Position: CHIEF FINANCIAL OFFICER
Credential: CPA, MBA
Phone: 312-592-6808