| Illinois Valley Primary Care, Ltd | |
|
1209 Starfire Dr #4 Ottawa IL 61350-1614 | |
| (815) 434-4900 | |
| (815) 434-2765 |
| Full Name | Illinois Valley Primary Care, Ltd |
|---|---|
| Speciality | Internal Medicine |
| Location | 1209 Starfire Dr, Ottawa, Illinois |
| Authorized Official Name and Position | Dawn Miesner (OWNER/PHYSICIAN) |
| Authorized Official Contact | 8154344900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Illinois Valley Primary Care, Ltd 1209 Starfire Dr #4 Ottawa IL 61350-1614 Ph: (815) 434-4900 | Illinois Valley Primary Care, Ltd 1209 Starfire Dr #4 Ottawa IL 61350-1614 Ph: (815) 434-4900 |
| NPI Number | 1851582928 |
|---|---|
| Provider Enumeration Date | 08/05/2007 |
| Last Update Date | 10/02/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851582928 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (Illinois) | Primary |
| 207V00000X | Obstetrics & Gynecology | (Illinois) | Secondary |
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