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General NPI Number Information
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NPI Number | 1437103231
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Entity Type | Organization
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Legal Business Name | PROCTOR HEALTH SYSTEMS
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 03/01/2010
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Provider Practice Location Address
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Address Line | 1506 W GARFIELD AVE
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City | BARTONVILLE
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State | IL
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Zip | 61607-1755
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Country | US
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Telephone | 309-698-2416
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Fax | 309-697-2749
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Provider Business Mailing Address
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Address Line | 1506 W GARFIELD AVE
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City | BARTONVILLE
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State | IL
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Zip | 61607-1755
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Country | US
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Telephone | 309-697-2416
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Fax | 309-697-2749
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MICHELE WALDBEESSER
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Credential |
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Telephone | 309-697-2416
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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