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120 E Gale St Williamsfield IL 61489-5418 | |
(309) 639-4004 | |
(309) 639-4065 |
Full Name | |
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Speciality | Clinic/Center |
Location | 120 E Gale St, Williamsfield, Illinois |
Authorized Official Name and Position | Janelle M Postin (CREDENTIALING SPECIALIST) |
Authorized Official Contact | 3096475240 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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180 S Main St Canton IL 61520-2608 Ph: (309) 647-0201 | 120 E Gale St Williamsfield IL 61489-5418 Ph: (309) 639-4004 |
NPI Number | 1508463563 |
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Provider Enumeration Date | 10/02/2020 |
Last Update Date | 04/03/2023 |
Medicare PECOS PAC ID | 2769375021 |
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Medicare Enrollment ID | O20220725002615 |
Identifier | Type | State | Issuer |
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1508463563 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |