Healthcare Provider Details

I. General information

NPI: 1538239983
Provider Name (Legal Business Name): THE WOMEN'S AND FAMILY CENTER FOR HEALTH, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 10/09/2023
Certification Date: 10/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 N PARKWAY DR
PEKIN IL
61554-3932
US

IV. Provider business mailing address

101 N PARKWAY DR
PEKIN IL
61554-3932
US

V. Phone/Fax

Practice location:
  • Phone: 309-478-1700
  • Fax: 309-478-1701
Mailing address:
  • Phone: 309-478-1700
  • Fax: 309-478-1701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER FEENEY
Title or Position: OFFICE MANAGER
Credential:
Phone: 309-478-1700