EASTLAND MEDICAL PLAZA SURGICENTER, LLC is an ambulatory surgical clinic center in Bloomington, IL. EASTLAND MEDICAL PLAZA SURGICENTER, LLC NPI is 1699751289. The provider is registered as an organization entity type.
The provider's business location address is:
1505 EASTLAND DR
BLOOMINGTON, IL
ZIP 61701-534
Phone: (309) 663-1997
Fax: (309) 662-9527
The provider's authorized official is Jackie Ann Frye .
The authorized official title is Business Office Manager and has the following contact phone number (309) 663-1997.
The CLIA number assigned to this NPI record is 14D0715300 - ambulatory surgery center with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 12/16/2005 and was last updated on 1/6/2010.