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331 S Main St Virginia IL 62691-1519 | |
(217) 452-3057 | |
(217) 452-7245 |
Full Name | |
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Speciality | Clinic/Center |
Location | 331 S Main St, Virginia, Illinois |
Authorized Official Name and Position | Teresa L Armstrong (ADMINISTRATOR) |
Authorized Official Contact | 2174523057 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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331 S Main St Virginia IL 62691-1519 Ph: (217) 452-3057 | 331 S Main St Virginia IL 62691-1519 Ph: (217) 452-3057 |
NPI Number | 1164596375 |
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Provider Enumeration Date | 11/20/2006 |
Last Update Date | 07/07/2022 |
Medicare PECOS PAC ID | 5395745137 |
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Medicare Enrollment ID | O20070202000246 |
Identifier | Type | State | Issuer |
---|---|---|---|
1164596375 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Provider Name | Dirck Curry |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1952339293 PECOS PAC ID: 1850363722 Enrollment ID: I20051116000366 |
Provider Name | Abdul W Royeen |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1821227976 PECOS PAC ID: 8022287754 Enrollment ID: I20110812000623 |
Provider Name | Emily Eichelberger |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1346788197 PECOS PAC ID: 9436433141 Enrollment ID: I20171117000945 |
Provider Name | Kylea Tibbs-hnizdo |
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Provider Type | Practitioner - Dentist |
Provider Identifiers | NPI Number: 1174807705 PECOS PAC ID: 7113203993 Enrollment ID: I20200921000436 |
Provider Name | Suzanne Filbert |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1902430523 PECOS PAC ID: 9638507833 Enrollment ID: I20220801001798 |
Provider Name | Tammy S Teel |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1952621922 PECOS PAC ID: 1052704111 Enrollment ID: I20240110003307 |
Provider Name | Angela Jean Kemner |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1295831600 PECOS PAC ID: 2264870955 Enrollment ID: I20240401000538 |