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118 N Walnut St Assumption IL 62510-1082 | |
(217) 226-3133 | |
(217) 226-4311 |
Full Name | |
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Speciality | Clinic/Center |
Location | 118 N Walnut St, Assumption, Illinois |
Authorized Official Name and Position | Lisa Bloemer (PRACTICE MANAGER) |
Authorized Official Contact | 2175626246 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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101 E 9th St Pana IL 62557-1716 Ph: (217) 562-6246 | 118 N Walnut St Assumption IL 62510-1082 Ph: (217) 226-3133 |
NPI Number | 1760932248 |
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Provider Enumeration Date | 10/10/2016 |
Last Update Date | 10/10/2016 |
Medicare PECOS PAC ID | 3274437348 |
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Medicare Enrollment ID | O20170119001996 |
Identifier | Type | State | Issuer |
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1760932248 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (Illinois) | Primary |