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3 Doctors Park Gibson City IL 60936-2000 | |
(217) 784-4030 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 3 Doctors Park, Gibson City, Illinois |
Authorized Official Name and Position | Matthew Ertel (CHIEF FINANCIAL OFFICER) |
Authorized Official Contact | 2177842601 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1120 N Melvin St Gibson City IL 60936-1477 Ph: (217) 784-4251 | 3 Doctors Park Gibson City IL 60936-2000 Ph: (217) 784-4030 |
NPI Number | 1740641745 |
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Provider Enumeration Date | 03/18/2016 |
Last Update Date | 07/30/2024 |
Medicare PECOS PAC ID | 5092703124 |
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Medicare Enrollment ID | O20110525000562 |
Identifier | Type | State | Issuer |
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1740641745 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Neil R Nelson Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8 Doctors Park, Gibson City, IL 60936 Phone: 217-784-8580 Fax: 217-784-8586 | |
Gibson City Clinic Sc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 222 N Sangamon Ave, Gibson City, IL 60936 Phone: 217-784-8148 Fax: 217-784-8160 | |