Full Name | |
---|---|
Speciality | Family Medicine |
Location | 911 4th St, Eldorado, Illinois |
Authorized Official Name and Position | Patrick Edward Peterson (HEALTHCARE PROVIDER) |
Authorized Official Contact | 6182732100 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
210 Blue Earth Ln Harrisburg IL 62946-4576 Ph: () - | 911 4th St Eldorado IL 62930-1203 Ph: (618) 273-2100 |
NPI Number | 1679540686 |
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Provider Enumeration Date | 03/08/2006 |
Last Update Date | 09/12/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1679540686 | NPI | - | NPPES |
0361037154 | Medicaid | IL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 036103715 (Illinois) | Primary |
Albert G Bledig Md Chartered Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1405 Locust St, Eldorado, IL 62930 Phone: 618-273-5511 Fax: 618-273-3322 | |
Peterson Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 911 4th St, Eldorado, IL 62930 Phone: 618-273-2100 Fax: 618-273-2110 |