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625 S 5th St Suite A Watseka IL 60970-1835 | |
(815) 432-0740 | |
(815) 432-0742 |
Full Name | |
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Speciality | Clinic/center |
Location | 625 S 5th St, Watseka, Illinois |
Authorized Official Name and Position | Chuck Bohlmann (CEO) |
Authorized Official Contact | 8154327736 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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625 S 5th St Suite A Watseka IL 60970-1835 Ph: (815) 432-0740 | 625 S 5th St Suite A Watseka IL 60970-1835 Ph: (815) 432-0740 |
NPI Number | 1740538958 |
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Provider Enumeration Date | 08/17/2012 |
Last Update Date | 09/22/2014 |
Identifier | Type | State | Issuer |
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1740538958 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (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 | |