Local City Search for Surgeons and Surgical Clinics EASTLAND MEDICAL PLAZA SURGICENTER, LLC
Surgery Yellow Pages
Bloomington, Illinois
Provider NPI: 1699751289
Organization Information:Organization Name: EASTLAND MEDICAL PLAZA SURGICENTER, LLC
Practice Location:
1505 EASTLAND DR BLOOMINGTON, IL 61701 US
Tel: 309-663-1997 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
1505 EASTLAND DR BLOOMINGTON, IL 61701 US
Tel: 309-663-1997 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 261QA1903X | Ambulatory Health Care Facilities Clinic/Center Ambulatory Surgical | IL | 7002413 |
Other Provider Identifiers:
| Issuer | Number | State | Type |
|---|---|---|---|
| STATE LICENSE | 7002413 | IL | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
