| Central Illinois Snf Care Pllc | |
|
1517 W Walnut St Jacksonville IL 62650-1133 | |
| (630) 336-5620 | |
| Not Available |
| Full Name | Central Illinois Snf Care Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1517 W Walnut St, Jacksonville, Illinois |
| Authorized Official Name and Position | Bhavin Vallabhbhai Sonani (PRESIDENT / OWNER) |
| Authorized Official Contact | 6303365620 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Central Illinois Snf Care Pllc 1517 W Walnut St Jacksonville IL 62650-1133 Ph: (630) 336-5620 | Central Illinois Snf Care Pllc 1517 W Walnut St Jacksonville IL 62650-1133 Ph: (630) 336-5620 |
| NPI Number | 1063103190 |
|---|---|
| Provider Enumeration Date | 05/18/2023 |
| Last Update Date | 10/03/2023 |
| Medicare PECOS PAC ID | 7810354156 |
|---|---|
| Medicare Enrollment ID | O20230601001588 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063103190 | NPI | - | NPPES |
| F100967946 | Other | IL | MEDICARE GROUP PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 208M00000X | Hospitalist | (* (Not Available)) | Secondary |
| Provider Name | Bhavin Vallabhbhai Sonani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639495971 PECOS PAC ID: 7315101334 Enrollment ID: I20120604000104 |
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