| Aces | |
|
217 N Broadway Ave Urbana IL 61801-2706 | |
| (217) 344-2671 | |
| (217) 344-2819 |
| Full Name | Aces |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 217 N Broadway Ave, Urbana, Illinois |
| Authorized Official Name and Position | Lori Ann Driver-dixon (OFFICE MANAGER) |
| Authorized Official Contact | 2173442671 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Aces 217 N Broadway Ave Urbana IL 61801-2706 Ph: (217) 344-2671 | Aces 217 N Broadway Ave Urbana IL 61801-2706 Ph: (217) 344-2671 |
| NPI Number | 1821202417 |
|---|---|
| Provider Enumeration Date | 05/10/2007 |
| Last Update Date | 10/06/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821202417 | NPI | - | NPPES |
| 0001032040 | Other | IL | BLUE SHIELD ID # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | A-7511-0001-A (Illinois) | Primary |
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