OrganizationActive
Central Illinois Friends of Pwa, Inc.
NPI 1932058963 · Community Health Clinic/Center · Galesburg, IL
Provider details
- NPI number
- 1932058963
- Entity type
- Organization
- Primary specialty
- Community Health Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Deric Kimler, Executive Director(309) 431-5880
Specialties & taxonomies
Ambulatory Health Care Facilities
- Public Health or Welfare Agency251K00000X
Agencies
Ambulatory Health Care Facilities
Practice location
311 E Main St Ste 409
Galesburg, IL 61401-4867
Phone: (309) 431-5880
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 5022
Peoria, IL 61601-5022
Registry dates
- Enumerated
- 2026-01-23
- Last updated
- 2026-05-08
- Certified
- 2026-05-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.