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1007 Us Highway 45 N Eldorado IL 62930-3767 | |
(618) 273-7723 | |
(618) 252-4027 |
Full Name | |
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Speciality | Clinic/Center |
Location | 1007 Us Highway 45 N, Eldorado, Illinois |
Authorized Official Name and Position | Warren P Ladner (SENIOR VP CHIEF FINANCIAL OFFICER) |
Authorized Official Contact | 6184575200 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 3988 Carbondale IL 62902-3988 Ph: (618) 457-5200 | 1007 Us Highway 45 N Eldorado IL 62930-3767 Ph: (618) 273-7723 |
NPI Number | 1073646436 |
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Provider Enumeration Date | 03/14/2007 |
Last Update Date | 01/07/2025 |
Medicare PECOS PAC ID | 9638083884 |
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Medicare Enrollment ID | O20100520000473 |
Identifier | Type | State | Issuer |
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1073646436 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | 0000521 (Illinois) | Primary |
Albert G Bledig Md Chartered Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1405 Locust St, Eldorado, IL 62930 Phone: 618-273-5511 Fax: 618-273-3322 | |
Peterson Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 911 4th St, Eldorado, IL 62930 Phone: 618-273-2100 Fax: 618-273-2110 |