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601 W Washington St # 1 Newton IL 62448-1264 | |
(618) 783-0954 | |
(618) 783-0958 |
Full Name | |
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Speciality | Clinic/Center |
Location | 601 W Washington St # 1, Newton, Illinois |
Authorized Official Name and Position | Andrew Watson (CFO) |
Authorized Official Contact | 2174925806 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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3051 Hollis Dr Fl 2 Springfield IL 62704-7450 Ph: () - | 601 W Washington St # 1 Newton IL 62448-1264 Ph: (618) 783-0954 |
NPI Number | 1679236533 |
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Provider Enumeration Date | 10/18/2021 |
Last Update Date | 08/17/2022 |
Medicare PECOS PAC ID | 5092857821 |
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Medicare Enrollment ID | O20211229001346 |
Identifier | Type | State | Issuer |
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1679236533 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Mid-illinois Medical Care Associates, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 601 W Washington St Ste 1, Newton, IL 62448 Phone: 618-783-0954 Fax: 618-783-0958 |