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General NPI Number Information
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NPI Number | 1326253873
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Entity Type | Organization
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Legal Business Name | FLEMING OBSTETRICAL & GYNECOLOGICAL SERVICES LTD
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 01/14/2008
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Provider Practice Location Address
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Address Line | 900 MAIN ST SUITE 360
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City | PEORIA
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State | IL
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Zip | 61602-5017
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Country | US
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Telephone | 309-673-3743
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Fax |
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Provider Business Mailing Address
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Address Line | 900 MAIN STREET SUITE 360
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City | PEORIA
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State | IL
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Zip | 61602-5017
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Country | US
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Telephone | 309-673-3743
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Fax |
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Authorized Official
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Title or Position | BILLING SPECIALIST
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Name | MS. KANDY LYNN POLLITT
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Credential |
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Telephone | 309-673-6791
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State | IL
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