Carly Tock, | |
1400 W Park St, Urbana, IL 61801-2334 | |
(217) 337-2000 | |
Not Available |
Full Name | Carly Tock |
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Gender | Female |
Speciality | Dietitian, Registered |
Location | 1400 W Park St, Urbana, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1447842299 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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133V00000X | Dietitian, Registered | 164008276 (Illinois) | Primary |
Provider Name | Gibson Community Hospital Association |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1114935681 PECOS PAC ID: 5092703124 Enrollment ID: O20040505001293 |
Mailing Address | Practice Location Address |
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Carly Tock, 407 Orchard Dr, Mahomet, IL 61853-3687 Ph: () - | Carly Tock, 1400 W Park St, Urbana, IL 61801-2334 Ph: (217) 337-2000 |
Jennifer Caulfield, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: Carle Clinic, 602 West University Avenue, Endocrinology, Urbana, IL 61801 Phone: 217-383-5346 | |
Angela Todd, Dietitian Medicare: Not Enrolled in Medicare Practice Location: Provena Covenant Medical Center, 1400 West Park Street, Urbana, IL 61801 Phone: 217-337-4520 | |
Melissa Schumacher, Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1400 W Park St, Nutrition Services, Urbana, IL 61801 Phone: 217-337-4520 | |
Shelly Palmer, MS, RDN, LDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 905 S Goodwin Ave Ofc 567, Urbana, IL 61801 Phone: 217-300-2216 | |
Noelle Park, Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1400 W Park St, Urbana, IL 61801 Phone: 217-337-2000 | |
Audra Leigh Cisna, RDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1400 W Park St, Urbana, IL 61801 Phone: 217-337-2890 |