OrganizationActive
Central Illinois Friends of Pwa, Inc.
NPI 1376492306 · Community Health Nurse Practitioner · Peoria, IL
Provider details
- NPI number
- 1376492306
- Entity type
- Organization
- Primary specialty
- Community Health Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Authorized official
- Deric Kimler, Executive Director
Practice location
120 Ne Glen Oak Ave Ste 201
Peoria, IL 61603-4315
Phone: (309) 431-5880
Mailing address
Po Box 5022
Peoria, IL 61601-5022
Registry dates
- Enumerated
- 2026-01-23
- Last updated
- 2026-01-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.