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100 E Us Highway 36 Atwood IL 61913-7233 | |
(217) 578-3814 | |
(217) 578-3100 |
Full Name | |
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Speciality | Clinic/Center |
Location | 100 E Us Highway 36, Atwood, Illinois |
Authorized Official Name and Position | Steven D Tenhouse (CEO) |
Authorized Official Contact | 2177621501 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1000 Medical Center Dr Monticello IL 61856-2116 Ph: (217) 762-2115 | 100 E Us Highway 36 Atwood IL 61913-7233 Ph: (217) 578-3814 |
NPI Number | 1740271667 |
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Provider Enumeration Date | 10/31/2005 |
Last Update Date | 09/02/2021 |
Medicare PECOS PAC ID | 6901791144 |
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Medicare Enrollment ID | O20050502000291 |
Identifier | Type | State | Issuer |
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1740271667 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | 0002758 (Illinois) | Primary |