| Danville Neurology, Llc | |
|
701 W Fairchild St Lower Level Danville IL 61832-3745 | |
| (217) 431-8400 | |
| (217) 431-0387 |
| Full Name | Danville Neurology, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 701 W Fairchild St, Danville, Illinois |
| Authorized Official Name and Position | Wahid A Tazudeen (OWNER) |
| Authorized Official Contact | 2174318400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Danville Neurology, Llc 701 W Fairchild St Lower Level Danville IL 61832-3745 Ph: (217) 431-8400 | Danville Neurology, Llc 701 W Fairchild St Lower Level Danville IL 61832-3745 Ph: (217) 431-8400 |
| NPI Number | 1275940959 |
|---|---|
| Provider Enumeration Date | 07/15/2014 |
| Last Update Date | 07/15/2014 |
| Medicare PECOS PAC ID | 2062638745 |
|---|---|
| Medicare Enrollment ID | O20140801001807 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275940959 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (Illinois) | Primary |
| Provider Name | Wahid Tazudeen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1104008606 PECOS PAC ID: 5698927341 Enrollment ID: I20140801001943 |
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