Unknown Individual – Urology Physician, NPI 1205827136
Urology Physician
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Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
5401, North Knoxville Avenue, Peoria, Peoria County, Illinois, 61614, United States
SUITE 112
PEORIA, IL 616145021
Phone: (309) 692-5828
Fax: (309) 692-5904
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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Medicare Utilization (FFS)
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 61614)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | CA | |
| - | CA | |
| Nurse Practitioner | CA | |
| Nurse Practitioner | CA | |
| Nurse Practitioner | CA | |
| - | CA | |
| - | CA | |
| - | CA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | CA | |
| Internal Medicine | CA |
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