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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:

PrimaryCodeCategory/DescriptionStateLicense Number
Y261QA1903XAmbulatory Health Care Facilities
Clinic/Center
Ambulatory Surgical
IL7002413

Other Provider Identifiers:

IssuerNumberStateType
STATE LICENSE7002413IL01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin



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