| Mclean County Neurology Sc | |
|
2204 Eastland Dr Bloomington IL 61704-3566 | |
| (309) 662-9461 | |
| Not Available |
| Full Name | Mclean County Neurology Sc |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 2204 Eastland Dr, Bloomington, Illinois |
| Authorized Official Name and Position | Herman Justus Dick (MANAGING PARTNER) |
| Authorized Official Contact | 3096629461 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mclean County Neurology Sc 2204 Eastland Dr Bloomington IL 61704-3566 Ph: (309) 662-9461 | Mclean County Neurology Sc 2204 Eastland Dr Bloomington IL 61704-3566 Ph: (309) 662-9461 |
| NPI Number | 1760431712 |
|---|---|
| Provider Enumeration Date | 05/08/2006 |
| Last Update Date | 06/05/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760431712 | NPI | - | NPPES |
| CF6543 | Other | IL | MEDID |
| 5715381 | Other | IL | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
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