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1400 W Park St Building 3 Urbana IL 61801 | |
| (217) 356-1558 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 1400 W Park St, Urbana, Illinois |
| Authorized Official Name and Position | Jennifer Henry (CEO) |
| Authorized Official Contact | 2174035401 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
819 Bloomington Rd Champaign IL 61820-2101 Ph: (217) 356-1558 | 1400 W Park St Building 3 Urbana IL 61801 Ph: (217) 356-1558 |
| NPI Number | 1174932586 |
|---|---|
| Provider Enumeration Date | 08/11/2014 |
| Last Update Date | 06/03/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174932586 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
Community Health Partnership Of Illinois Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 21 West Kenyon Road, Urbana, IL 61820 Phone: 217-893-3052 Fax: 217-893-8600 | |
Carle Foundation Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 602 W University Ave, Sc-2, Urbana, IL 61801 Phone: 217-383-3302 | |
Carle Foundation Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 602 W University Ave, Sc-2, Urbana, IL 61801 Phone: 217-383-3170 |