Full Name | |
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Speciality | Family Medicine |
Location | 326 N 24th St, Quincy, Illinois |
Authorized Official Name and Position | Timothy Moore (VP FINANCE, CAO) |
Authorized Official Contact | 2172238400 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1005 Broadway St Quincy IL 62301-2834 Ph: (217) 223-8400 | 326 N 24th St Quincy IL 62301-3140 Ph: (217) 223-8400 |
NPI Number | 1578087052 |
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Provider Enumeration Date | 07/27/2017 |
Last Update Date | 04/05/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1578087052 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (Illinois) | Primary |
Blessing Walk-in Clinic Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3700 Broadway St, Quincy, IL 62305 Phone: 217-228-1060 | |
Board Of Trustees Of Southern Illinois University Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 205 S 24th St Ste 100, Quincy, IL 62301 Phone: 217-224-9484 Fax: 217-224-7950 |