Provider Demographics
NPI:1689991929
Name:BLOOMINGTON PRIMARY CARE, LTD.
Entity Type:Organization
Organization Name:BLOOMINGTON PRIMARY CARE, LTD.
Other - Org Name:STEPHEN C. PILCHER, MD, LTS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:C
Authorized Official - Last Name:PILCHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:309-663-7642
Mailing Address - Street 1:9 HEARTLAND DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61704-7732
Mailing Address - Country:US
Mailing Address - Phone:309-663-7642
Mailing Address - Fax:309-663-8359
Practice Address - Street 1:9 HEARTLAND DR
Practice Address - Street 2:SUITE C
Practice Address - City:BLOOMINGTON
Practice Address - State:IL
Practice Address - Zip Code:61704-7732
Practice Address - Country:US
Practice Address - Phone:309-663-7642
Practice Address - Fax:309-663-8359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-27
Last Update Date:2017-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty