| Danville Polyclinic, Ltd | |
|
707 N Logan Ave Danville IL 61832-4360 | |
| (217) 446-6410 | |
| (217) 477-4757 |
| Full Name | Danville Polyclinic, Ltd |
|---|---|
| Speciality | Clinic/Center |
| Location | 707 N Logan Ave, Danville, Illinois |
| Authorized Official Name and Position | Melissa A Edington (ADMINISTRATOR) |
| Authorized Official Contact | 2174774750 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Danville Polyclinic, Ltd 707 N Logan Ave Danville IL 61832-4360 Ph: (217) 446-6410 | Danville Polyclinic, Ltd 707 N Logan Ave Danville IL 61832-4360 Ph: (217) 446-6410 |
| NPI Number | 1336181544 |
|---|---|
| Provider Enumeration Date | 06/12/2006 |
| Last Update Date | 11/25/2008 |
| Medicare PECOS PAC ID | 3072404060 |
|---|---|
| Medicare Enrollment ID | O20040320000701 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336181544 | NPI | - | NPPES |
| 100002020A | Medicaid | IN | |
| 221069 | Other | BLACK LUNG | |
| 09215807 | Other | IL | BCBS OF ILLINOIS |
| 1486765 | Other | UMWA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | 060000812 (Illinois) | Primary |
| Provider Name | Mark E Unzicker |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1881759967 PECOS PAC ID: 9234023458 Enrollment ID: I20040210000291 |
| Provider Name | Stuart L Rotramel |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1891708137 PECOS PAC ID: 8820983562 Enrollment ID: I20040220000173 |
| Provider Name | Julie Ann Earles |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1770658429 PECOS PAC ID: 7810886140 Enrollment ID: I20040313000405 |
| Provider Name | Robert E Kelsey |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1912918350 PECOS PAC ID: 3870525090 Enrollment ID: I20050908000201 |
| Provider Name | Aaron C Eubanks |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1144422726 PECOS PAC ID: 0446341564 Enrollment ID: I20081231000290 |
| Provider Name | William Jon Bowen |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1225019508 PECOS PAC ID: 2466464706 Enrollment ID: I20091211000231 |
| Provider Name | Venkat Sekar |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1114974441 PECOS PAC ID: 5799843975 Enrollment ID: I20100205000689 |
| Provider Name | Bhaskar Patel |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1588607014 PECOS PAC ID: 1254499437 Enrollment ID: I20100205000710 |
| Provider Name | Kirk Michael Bott |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1376655019 PECOS PAC ID: 3072700129 Enrollment ID: I20101215000385 |
| Provider Name | Mohannad Rajjoub |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1255659587 PECOS PAC ID: 3577757954 Enrollment ID: I20120808000934 |
| Provider Name | Rachel Hayden |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1942693692 PECOS PAC ID: 0749509297 Enrollment ID: I20150505000539 |
| Provider Name | Uma Sekar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174622849 PECOS PAC ID: 7618136284 Enrollment ID: I20150701000172 |
Carle Clinic Danville Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2300 N Vermilion St, Danville, IL 61832 Phone: 217-431-7600 | |
Provena Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 405 Sheridan St, Danville, IL 61832 Phone: 217-431-6330 | |
Carle Physician Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 311 W Fairchild St, Danville, IL 61832 Phone: 217-431-7600 | |
Muhammad Mushtaq Md Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 701 W Fairchild St, Suite B, Danville, IL 61832 Phone: 217-431-1100 Fax: 217-431-2900 | |
Vermilion Medical Center Ltd Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 701 West Fairchild Street, Suite A, Danville, IL 61832 Phone: 217-443-3866 Fax: 217-443-0216 | |
Va Illiana Healthcare System Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1900 E Main Street, Danville, IL 61832 Phone: 217-554-5630 | |
Hyster-yale - Danville Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1010 E Fairchild St, Danville, IL 61832 Phone: 217-443-7102 Fax: 615-369-8788 |