Full Name | |
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Speciality | Clinic/Center |
Location | 1602 Il Hwy 1, Marshall, Illinois |
Authorized Official Name and Position | Martin Adams (CFO) |
Authorized Official Contact | 2174664246 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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727 E Court St Paris IL 61944-2460 Ph: (217) 465-8411 | 1602 Il Hwy 1 Marshall IL 62441 Ph: (217) 826-3299 |
NPI Number | 1760950737 |
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Provider Enumeration Date | 11/08/2018 |
Last Update Date | 09/08/2021 |
Medicare PECOS PAC ID | 7315933827 |
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Medicare Enrollment ID | O20190627001981 |
Identifier | Type | State | Issuer |
---|---|---|---|
1760950737 | NPI | - | NPPES |