Healthcare Provider Details

I. General information

NPI: 1578457966
Provider Name (Legal Business Name): OSF MULTI-SPECIALTY GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2025
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 N KNOXVILLE AVE
PEORIA IL
61603-3028
US

IV. Provider business mailing address

124 SW ADAMS ST
PEORIA IL
61602-1308
US

V. Phone/Fax

Practice location:
  • Phone: 309-308-0900
  • Fax:
Mailing address:
  • Phone: 309-655-2850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: KIRSTEN MARIE LARGENT
Title or Position: CFO
Credential:
Phone: 309-308-5255