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ILLINIOS VALLEY ORAL SURGEONS P.C. NPI 1598974651


NPI Information

NPI: 1598974651
Provider Name: ILLINIOS VALLEY ORAL SURGEONS, P.C.
Classification: Clinic/Center - 261QS0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

Address:
2050 MARQUETTE RD
PERU, IL
ZIP 61354
Phone: (815) 224-1534
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ILLINIOS VALLEY ORAL SURGEONS, P.C. is an oral and maxillofacial surgery clinic center in Peru, IL. The provider is an oral and maxillofacial surgery clinic or center specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. ILLINIOS VALLEY ORAL SURGEONS, P.C. NPI is 1598974651. The provider is registered as an organization entity type.

The provider's business location address is:

2050 MARQUETTE RD
PERU, IL
ZIP 61354-597
Phone: (815) 224-1534
Fax: (815) 224-3018

The provider's authorized official is Thomas P Rooney .
The authorized official title is President and has the following contact phone number (815) 224-1534.

The enumeration date for this NPI number is 5/22/2007 and was last updated on 3/13/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QS0112XClinic/CenterOral and Maxillofacial SurgeryYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1773400MEDICARE ID-TYPE UNSPECIFIEDILLINOISPERU
2773401MEDICARE ID-TYPE UNSPECIFIEDILLINOISOTTAWA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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