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606 W Adams St Pittsfield IL 62363-1308 | |
(217) 285-4407 | |
(217) 285-4639 |
Full Name | |
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Speciality | Clinic/Center |
Location | 606 W Adams St, Pittsfield, Illinois |
Authorized Official Name and Position | Iris Wesley (CEO) |
Authorized Official Contact | 2175458000 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 19639 Springfield IL 62794-9639 Ph: (217) 545-7876 | 606 W Adams St Pittsfield IL 62363-1308 Ph: (217) 285-4407 |
NPI Number | 1619501871 |
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Provider Enumeration Date | 02/26/2020 |
Last Update Date | 01/09/2025 |
Medicare PECOS PAC ID | 4486667888 |
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Medicare Enrollment ID | O20200930002015 |
Identifier | Type | State | Issuer |
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1619501871 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |