Provider Demographics
NPI:1689079238
Name:INSPIRIT HEALTH PC
Entity Type:Organization
Organization Name:INSPIRIT HEALTH PC
Other - Org Name:LIFEPLUS MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GLEN
Authorized Official - Middle Name:N
Authorized Official - Last Name:FEATHER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:309-740-3744
Mailing Address - Street 1:6811 N KNOXVILLE AVE
Mailing Address - Street 2:STE A
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61614-2861
Mailing Address - Country:US
Mailing Address - Phone:309-740-3744
Mailing Address - Fax:
Practice Address - Street 1:6811 N KNOXVILLE AVE
Practice Address - Street 2:STE A
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61614-2861
Practice Address - Country:US
Practice Address - Phone:309-740-3744
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-24
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-007890111N00000X
IL036-079920208D00000X
IL036-114669208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty