| |
1007 Us Route 45 Eldorado IL 62930 | |
(618) 273-7723 | |
(618) 273-3384 |
Full Name | |
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Speciality | Clinic/center - Rural Health |
Location | 1007 Us Route 45, Eldorado, Illinois |
Authorized Official Name and Position | Rodney D Smith (PRESIDENT/CEO) |
Authorized Official Contact | 6182537671 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 250 Eldorado IL 62930-0250 Ph: (618) 273-7723 | 1007 Us Route 45 Eldorado IL 62930 Ph: (618) 273-7723 |
NPI Number | 1992773873 |
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Provider Enumeration Date | 03/08/2006 |
Last Update Date | 10/15/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1992773873 | NPI | - | NPPES |
143471 | Other | IL | HEALTHLINK |
8315011 | Other | IL | BLUE CROSS PROVIDER NUMBE |
817400 | Other | IL | WPS PROVIDER NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | 0000521 (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 |