Nicholas James Rogers
Psychiatry & Neurology, Psychiatry in Peoria, IL. Individual provider (NPI-1).
NPI number1164086385
StatusActive
Last updated in NPPESFeb 7, 2025
Details
- NPI
- 1164086385
- Entity type
- Individual (NPI-1)
- Name
- Nicholas James Rogers
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 23, 2019
- Certification date
- Feb 7, 2025
- Last updated
- Feb 7, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology, Psychiatry | 036.161219 | IL | Yes |
Practice location
900 Main StPeoria, IL 61602-1005
Phone 309-672-3100
Mailing address
221 Ne Glen Oak AvePeoria, IL 61636-0001
Phone 309-672-4974
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