Community Medical Clinic Of Table Grove | |
130 N Broadway St Table Grove IL 61482-9593 | |
(309) 758-5070 | |
Not Available |
Full Name | Community Medical Clinic Of Table Grove |
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Speciality | Clinic/center - Rural Health |
Location | 130 N Broadway St, Table Grove, Illinois |
Authorized Official Name and Position | Tamra S Gadberry (CFO) |
Authorized Official Contact | 2173225296 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Community Medical Clinic Of Table Grove 238 S Congress St Rushville IL 62681-1465 Ph: () - | Community Medical Clinic Of Table Grove 130 N Broadway St Table Grove IL 61482-9593 Ph: (309) 758-5070 |
NPI Number | 1194223719 |
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Provider Enumeration Date | 01/29/2018 |
Last Update Date | 11/09/2020 |
Identifier | Type | State | Issuer |
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1194223719 | NPI | - | NPPES |
14D2139536 | Other | IL | CLIA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Schuyler County Hospital District Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 130 N Broadway St, Table Grove, IL 61482 Phone: 309-758-5070 |