Organization · Type 2 NPI

Phillip A. Immesoete Md, Ltd

Nursing Facility/Intermediate Care Facility · Peoria, IL

NPI number 1245544543 Active

Practice location

5401 N Knoxville Ave, Suite 406
Peoria, IL 61614-5098

Fax (309) 691-9262

Specialties and licenses

TaxonomyCodeLicense
Nursing Facility/Intermediate Care Facility Primary 313M00000X036042568 (IL)

Nursing Facility/Intermediate Care Facility: An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical conditi…

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About NPI 1245544543

Phillip A. Immesoete Md, Ltd's National Provider Identifier is 1245544543, issued on Jul 29, 2010. The primary taxonomy on file is Nursing Facility/Intermediate Care Facility (313M00000X), and the practice location is in Peoria, IL. The record was last updated on Jul 29, 2010.