Organization · Type 2 NPI
Central Illinois Friends of Pwa, Inc.
Community Health Nurse Practitioner · Peoria, IL
NPI number
1376492306
Active
Practice location
120 NE Glen Oak Ave Ste 201
Peoria, IL 61603-4315
Mailing address
PO Box 5022
Peoria, IL 61601-5022
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Community Health Clinic/Center | 261QC1500X | None listed |
| Community Health Nurse Practitioner Primary | 363LC1500X | None listed |
Community Health Nurse Practitioner: Definition to come...
Other community health nurse practitioner providers in Peoria
About NPI 1376492306
Central Illinois Friends of Pwa, Inc.'s National Provider Identifier is 1376492306, issued on Jan 23, 2026. The primary taxonomy on file is Community Health Nurse Practitioner (363LC1500X), and the practice location is in Peoria, IL. The record was last updated on Jan 23, 2026.