| Community Medical Center Of Dwight Pc | |
|
103 S John St Dwight IL 60420-1413 | |
| (815) 584-3051 | |
| Not Available |
| Full Name | Community Medical Center Of Dwight Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 103 S John St, Dwight, Illinois |
| Authorized Official Name and Position | Pamela Marie Cichon (OFFICE MANAGER) |
| Authorized Official Contact | 8155843051 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Medical Center Of Dwight Pc 103 S John St Dwight IL 60420-1413 Ph: (815) 584-3051 | Community Medical Center Of Dwight Pc 103 S John St Dwight IL 60420-1413 Ph: (815) 584-3051 |
| NPI Number | 1487983060 |
|---|---|
| Provider Enumeration Date | 12/10/2009 |
| Last Update Date | 02/19/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487983060 | NPI | - | NPPES |
| 05315073 | Other | IL | BLUE CROSS BLUE SHIELD |
| 036062435 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 036062435 (Illinois) | Primary |
Osf Healthcare - Medical Group - Dwight Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 107 Watters Dr Ste 100, Dwight, IL 60420 Phone: 815-584-3343 Fax: 309-655-4878 | |
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