| Irvington Township Rural Health Clinic Llc | |
|
620 N Main St Hoyleton IL 62803-2046 | |
| (618) 663-0547 | |
| (418) 787-0423 |
| Full Name | Irvington Township Rural Health Clinic Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 620 N Main St, Hoyleton, Illinois |
| Authorized Official Name and Position | Kristina Orrill (OPERATIONS MANAGER) |
| Authorized Official Contact | 6186630547 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Irvington Township Rural Health Clinic Llc 620 N Main St Hoyleton IL 62803-2046 Ph: (618) 663-0547 | Irvington Township Rural Health Clinic Llc 620 N Main St Hoyleton IL 62803-2046 Ph: (618) 663-0547 |
| NPI Number | 1295940062 |
|---|---|
| Provider Enumeration Date | 05/14/2007 |
| Last Update Date | 01/25/2022 |
| Medicare PECOS PAC ID | 1850485624 |
|---|---|
| Medicare Enrollment ID | O20071001000595 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295940062 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | NONE (Illinois) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Lyle D Pahnke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770538225 PECOS PAC ID: 9931162302 Enrollment ID: I20041105001094 |
| Provider Name | Denise L Orrill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093961930 PECOS PAC ID: 1951477298 Enrollment ID: I20080910000214 |
| Provider Name | Bridget J Burwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588283360 PECOS PAC ID: 8224469069 Enrollment ID: I20200512002336 |
| Provider Name | Shannon D Parks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598308389 PECOS PAC ID: 7315369782 Enrollment ID: I20200612002006 |
Advanced Surgical Technology, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 28 N Main St, Hoyleton, IL 62803 Phone: 618-918-7777 Fax: 618-918-7782 |