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1107 College Ave Quincy IL 62301-2600 | |
(217) 223-8400 | |
Not Available |
Full Name | |
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Speciality | Nurse Practitioner |
Location | 1107 College Ave, Quincy, Illinois |
Authorized Official Name and Position | Timothy A Moore (CAO) |
Authorized Official Contact | 2172231200 |
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 | 1107 College Ave Quincy IL 62301-2600 Ph: (217) 223-8400 |
NPI Number | 1417204827 |
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Provider Enumeration Date | 08/06/2012 |
Last Update Date | 11/27/2023 |
Identifier | Type | State | Issuer |
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1417204827 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207QB0002X | Family Medicine - Obesity Medicine | (* (Not Available)) | Secondary |
363L00000X | Nurse Practitioner | (* (Not Available)) | 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 |