Basic Information
Provider Information
NPI: 1881893212
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GARCIA
FirstName: XOCHITL
MiddleName: LORENA
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 19248
Address2:  
City: SPRINGFIELD
State: IL
PostalCode: 627949248
CountryCode: US
TelephoneNumber: 2175287541
FaxNumber:  
Practice Location
Address1: 1001 MAIN ST STE 300
Address2:  
City: PEORIA
State: IL
PostalCode: 616062036
CountryCode: US
TelephoneNumber: 3094950200
FaxNumber: 3096766545
Other Information
ProviderEnumerationDate: 07/16/2007
LastUpdateDate: 02/02/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/02/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X036128250ILY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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