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

Peoria Tazewell Pathology Group, SC

Organization Anatomic Pathology & Clinical Pathology Physician · NPI 1578597738

Peoria Tazewell Pathology Group, SC is an Anatomic Pathology & Clinical Pathology Physician in Peoria, Illinois. Registered with an NPI since 2006.

In the registry since
2006

Practice location Address checks out

221 NE Glen Oak Ave
Peoria, IL 61603-4310
Phone: (309) 672-4911
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anatomic Pathology & Clinical Pathology Physician (primary) Taxonomy 207ZP0102X

Record details

NPI number1578597738
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ronald Champagne — President · (309) 647-5240
NPI enumeratedJuly 11, 2006
Last updated in NPPESAugust 13, 2012
Mailing addressPo Box 60070, N Charleston, SC 29419-0070

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