| Gibson Community Hospital Association | |
|
221 Wal Crest Dr Fairbury IL 61739-8998 | |
| (815) 692-1150 | |
| (815) 692-1153 |
| Full Name | Gibson Community Hospital Association |
|---|---|
| Speciality | Family Medicine |
| Location | 221 Wal Crest Dr, Fairbury, Illinois |
| Authorized Official Name and Position | Matthew Ertel (CFO) |
| Authorized Official Contact | 2177842600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gibson Community Hospital Association 221 Wal Crest Dr Fairbury IL 61739-8998 Ph: (815) 692-1150 | Gibson Community Hospital Association 221 Wal Crest Dr Fairbury IL 61739-8998 Ph: (815) 692-1150 |
| NPI Number | 1548544679 |
|---|---|
| Provider Enumeration Date | 10/07/2011 |
| Last Update Date | 11/08/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548544679 | NPI | - | NPPES |
| 825130 | Other | IL | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 0000836 (Illinois) | Primary |
Bromenn Physicians Management Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 115 E Walnut St, Fairbury, IL 61739 Phone: 815-692-2305 | |
Saint James Hospital Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 106 S 1st St, Fairbury, IL 61739 Phone: 815-692-2308 Fax: 815-692-3278 |