| Carle Clinic Association | |
|
701 Krebs Dr Champaign IL 61822 | |
| (217) 355-7951 | |
| Not Available |
| Full Name | Carle Clinic Association |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | 701 Krebs Dr, Champaign, Illinois |
| Authorized Official Name and Position | Zuheir Kassabo (HOSPITALIST) |
| Authorized Official Contact | 2173557951 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Carle Clinic Association 701 Krebs Dr Champaign IL 61822 Ph: () - | Carle Clinic Association 701 Krebs Dr Champaign IL 61822 Ph: (217) 355-7951 |
| NPI Number | 1609906999 |
|---|---|
| Provider Enumeration Date | 03/06/2007 |
| Last Update Date | 08/31/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609906999 | NPI | - | NPPES |
| 036115508 | Medicaid | IL | |
| CA2264 | Other | IL | RR GROUP # |
| 833120 | Other | MEDICARE GROUP # | |
| P00729199 | Other | IL | RR MEDICARE INDIVIDUAL # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 036-115508 (Illinois) | Secondary |
| 282N00000X | General Acute Care Hospital | 036-115508 (Illinois) | Primary |
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