Gibson Health Of Mahomet | |
1504 Patton Dr Ste 2 Mahomet IL 61853-8126 | |
(217) 586-2633 | |
(217) 590-0272 |
Full Name | Gibson Health Of Mahomet |
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Speciality | Clinic/Center |
Location | 1504 Patton Dr Ste 2, Mahomet, 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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Gibson Health Of Mahomet 1504 Patton Dr Ste 2 Mahomet IL 61853-8126 Ph: (217) 586-2633 | Gibson Health Of Mahomet 1504 Patton Dr Ste 2 Mahomet IL 61853-8126 Ph: (217) 586-2633 |
NPI Number | 1689198863 |
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Provider Enumeration Date | 07/31/2017 |
Last Update Date | 02/04/2022 |
Medicare PECOS PAC ID | 5092703124 |
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Medicare Enrollment ID | O20171006000117 |
Identifier | Type | State | Issuer |
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1689198863 | 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 |