Healthcare Provider Details

I. General information

NPI: 1841384898
Provider Name (Legal Business Name): HEALTH PROFESSIONALS, LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9000 N LINDBERGH DR
PEORIA IL
61615-1417
US

IV. Provider business mailing address

9000 N LINDBERGH DR
PEORIA IL
61615-1417
US

V. Phone/Fax

Practice location:
  • Phone: 309-676-4900
  • Fax: 309-676-4987
Mailing address:
  • Phone: 309-676-4900
  • Fax: 309-676-4987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number State

VIII. Authorized Official

Name: DR. THERESA FALCON-CULLINAN
Title or Position: CEO
Credential: MD, FACOG
Phone: 309-676-4900