| |
1002 N Allen St Robinson IL 62454-1167 | |
(618) 544-7050 | |
(618) 544-3738 |
Full Name | |
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Speciality | Family Medicine |
Location | 1002 N Allen St, Robinson, Illinois |
Authorized Official Name and Position | David D Rotman (PRESIDENT) |
Authorized Official Contact | 6185447050 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1002 N Allen St Robinson IL 62454-1167 Ph: (618) 544-7050 | 1002 N Allen St Robinson IL 62454-1167 Ph: (618) 544-7050 |
NPI Number | 1649271685 |
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Provider Enumeration Date | 08/01/2005 |
Last Update Date | 09/04/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1649271685 | NPI | - | NPPES |
036081314 | Medicaid | IL | |
L023973 | Other | IL | TRICARE/CHAMPUS |
080119162 | Other | IL | PALMENTO GBA MEDICARE |
170047 | Other | IL | BC/BS OF IL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 036081314 (Illinois) | Primary |
Michael W Elliott Ii Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 807 W Craft St, Robinson, IL 62454 Phone: 618-546-5052 Fax: 618-544-2094 | |