Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Eastland Medical Plaza Surgicenter, LLC

Organization Ambulatory Surgical Clinic/Center · NPI 1699751289

Eastland Medical Plaza Surgicenter, LLC is an Ambulatory Surgical Clinic/Center in Bloomington, Illinois. Licensed in Illinois. Registered with an NPI since 2005.

Licensed in
IL
In the registry since
2005
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1505 Eastland Dr
Bloomington, IL 61701-3534
Phone: (309) 663-1997
Fax: (309) 662-9527
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Ambulatory Surgical Clinic/Center (primary) Taxonomy 261QA1903X · Licence 7002413 (IL)

Record details

NPI number1699751289
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jackie Frye — Business Office Manager · (309) 663-1997
NPI enumeratedDecember 16, 2005
Last updated in NPPESJanuary 6, 2010
Mailing address1505 Eastland Dr, Bloomington, IL 61701-3534

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