| Carlinville Medical Clinic, Inc. | |
|
604 N. Broad Carlinville IL 62626 | |
| (217) 854-9411 | |
| (217) 854-2858 |
| Full Name | Carlinville Medical Clinic, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 604 N. Broad, Carlinville, Illinois |
| Authorized Official Name and Position | Margie Busby (OFFICE MANAGER) |
| Authorized Official Contact | 2178549411 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carlinville Medical Clinic, Inc. 604 N. Broad Carlinville IL 62626 Ph: (217) 854-9411 | Carlinville Medical Clinic, Inc. 604 N. Broad Carlinville IL 62626 Ph: (217) 854-9411 |
| NPI Number | 1730213026 |
|---|---|
| Provider Enumeration Date | 03/16/2007 |
| Last Update Date | 08/04/2020 |
| Medicare PECOS PAC ID | 7719933928 |
|---|---|
| Medicare Enrollment ID | O20050330000481 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730213026 | NPI | - | NPPES |
| 036057724 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 036057724 (Illinois) | Primary |
| 363LF0000X | Nurse Practitioner - Family | 209000907 (Illinois) | Secondary |
| Provider Name | Kamal K Chopra |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598762262 PECOS PAC ID: 9133105554 Enrollment ID: I20051212000217 |
| Provider Name | Mary Elizabeth Devries |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457869232 PECOS PAC ID: 5890056626 Enrollment ID: I20180219001528 |
Macoupin Physician Services, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 20733 N Broad St, Carlinville, IL 62626 Phone: 217-854-3141 | |
Lydia S Q Villafuerte Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 205 Oakland Ave, Carlinville, IL 62626 Phone: 217-854-6262 Fax: 217-854-6264 | |
Macoupin County Public Health Department Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 205 Oakland Ave, Carlinville, IL 62626 Phone: 217-854-3223 Fax: 217-854-3225 | |
Carlinville Rural Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 20613 N Broad St, Carlinville, IL 62626 Phone: 217-854-5099 | |
Carlinville Medical Clinic, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 604 N Broad St, Carlinville, IL 62626 Phone: 217-854-9411 Fax: 217-854-2858 | |
Carlinville Family Practice Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 15574 Route 108, Carlinville, IL 62626 Phone: 121-785-4431 | |
Carlinville Family Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 15574 Route 108, Carlinville, IL 62626 Phone: 217-854-4319 Fax: 217-854-2765 |