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301 E Southline Rd Tuscola IL 61953-2014 | |
(217) 253-5231 | |
(217) 253-4082 |
Full Name | |
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Speciality | Clinic/Center |
Location | 301 E Southline Rd, Tuscola, Illinois |
Authorized Official Name and Position | Harry Brockus (CEO) |
Authorized Official Contact | 2172838540 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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611 W Park St Urbana IL 61801-2500 Ph: (217) 383-3311 | 301 E Southline Rd Tuscola IL 61953-2014 Ph: (217) 253-5231 |
NPI Number | 1205230844 |
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Provider Enumeration Date | 10/10/2014 |
Last Update Date | 10/10/2014 |
Medicare PECOS PAC ID | 3577456037 |
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Medicare Enrollment ID | O20141105000066 |
Identifier | Type | State | Issuer |
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1205230844 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (Illinois) | Primary |
Carle Clinic Association, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 301 E Southline Rd, Tuscola, IL 61953 Phone: 217-253-5231 | |
Douglas County Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1250 E Us Highway 36, Tuscola, IL 61953 Phone: 217-253-4137 Fax: 217-599-3854 |