PEORIA OBSTETRICS & GYNECOLOGY, S.C. - NPI 1477672020 - Obstetrics & Gynecology in Peoria, IL

Q: What is Peoria Obstetrics & Gynecology, S.C.'s NPI number?

The NPI number for Peoria Obstetrics & Gynecology, S.C. is 1477672020. It was assigned to this organization in the NPPES registry on March 28, 2007.

Q: What is Peoria Obstetrics & Gynecology, S.C.'s specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

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About Peoria Obstetrics & Gynecology, S.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PEORIA OBSTETRICS & GYNECOLOGY, S.C. (NPI 1477672020) is a healthcare organization registered as an obstetrics & gynecology in Peoria, Illinois and active in the NPI registry since March 2007. The organization lists Paula M Clark, Practice Administrator, as its authorized official.

NPPES Registry Identity

NPI1477672020

Entity TypeOrganization

Primary Taxonomy207V00000X

Legal Business NamePEORIA OBSTETRICS & GYNECOLOGY, S.C.

Location Address900 MAIN ST STE 660Peoria, IL 61602-1060

Mailing Address900 Main St Ste 660Peoria, IL 61602-1060 · (309) 687-4230 · Fax (309) 272-7704

Phone(309) 687-4230

Fax(309) 272-7704

Organization SubpartNo

Authorized OfficialPaula M ClarkPractice Administrator · (309) 687-4242

Enumeration DateMarch 28, 2007

Last NPPES UpdateJanuary 26, 2009

✔ NPI 1477672020 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians

Taxonomy Code207V00000X

License✔ Licensed in IL · 036084069

Definition

An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

900 MAIN ST STE 660, Peoria, IL 61602

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Other Identifiers 7

Medicaid036062138IL

Medicaid036044919IL

Medicaid036108543IL

Medicaid036084069IL

Medicaid036111906IL

Medicaid036065639IL

Medicaid036098292IL

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. DANA HUMES GOFF A.P.N., C.N.M.

Advanced Practice Midwife