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200 Laird Ln Watseka IL 60970-7568 | |
(815) 432-5411 | |
(815) 432-3955 |
Full Name | |
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Speciality | Clinic/Center |
Location | 200 Laird Ln, Watseka, Illinois |
Authorized Official Name and Position | Chuck Bohlmann (CEO) |
Authorized Official Contact | 8154357735 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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200 Laird Ln Watseka IL 60970-7568 Ph: (815) 432-5411 | 200 Laird Ln Watseka IL 60970-7568 Ph: (815) 432-5411 |
NPI Number | 1447610472 |
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Provider Enumeration Date | 03/03/2016 |
Last Update Date | 03/03/2016 |
Medicare PECOS PAC ID | 4385551258 |
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Medicare Enrollment ID | O20150513002309 |
Identifier | Type | State | Issuer |
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1447610472 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Gonzalo T Florido Md Sc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 714 S 10th St, Watseka, IL 60970 Phone: 815-432-6744 | |