Organization Name: | TEVERBAUGH CROLAND & MUELLER OB/GYN & ASSOCIATES, S.C. |
NPI Number: | 1720031602 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LORI A. TEVERBAUGH (PRESIDENT) |
Mailing Address: | 8600 N. Rt 91 #330 Peoria |
State: | IL US |
Postal Code: | 61615 |
Phone Number: | 3096922025 |
Fax Number: | 3096922446 |
NPI Enumeration Date: | 05/19/2006 |
NPI Last Update Date: | 06/20/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 036102227 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IL |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |