| Cissna Park Medical Clinic | |
|
141 W. Garfield Ave Cissna Park IL 60924-0502 | |
| (217) 283-5531 | |
| (217) 283-7981 |
| Full Name | Cissna Park Medical Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 141 W. Garfield Ave, Cissna Park, 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 |
|---|---|
| Cissna Park Medical Clinic 701 E Orange St Hoopeston IL 60942-1801 Ph: (217) 383-6792 | Cissna Park Medical Clinic 141 W. Garfield Ave Cissna Park IL 60924-0502 Ph: (217) 283-5531 |
| NPI Number | 1356382428 |
|---|---|
| Provider Enumeration Date | 06/09/2006 |
| Last Update Date | 02/06/2014 |
| Medicare PECOS PAC ID | 3577456037 |
|---|---|
| Medicare Enrollment ID | O20060724000240 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356382428 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 0004200 (Illinois) | Primary |
Family Health Care Of Cissna Park Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 510 Prairie Ln Unit B, Cissna Park, IL 60924 Phone: 815-457-2000 Fax: 815-457-2015 |