| |
520 W Walnut St Oglesby IL 61348-1400 | |
(815) 883-3588 | |
(815) 883-2604 |
Full Name | |
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Speciality | Clinic/center |
Location | 520 W Walnut St, Oglesby, Illinois |
Authorized Official Name and Position | Dorinda Bonnell (DIRECTOR OF PHYSICIAN PRACTICES) |
Authorized Official Contact | 8157803222 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1305 6th St Peru IL 61354-2759 Ph: (815) 780-4619 | 520 W Walnut St Oglesby IL 61348-1400 Ph: (815) 883-3588 |
NPI Number | 1427421924 |
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Provider Enumeration Date | 11/05/2015 |
Last Update Date | 01/28/2021 |
Identifier | Type | State | Issuer |
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1427421924 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 085005712 (Illinois) | Primary |
261QU0200X | Clinic/center - Urgent Care | 085005712 (Illinois) | Secondary |
Mendota Community Hospital Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 790 W Walnut St, Oglesby, IL 61348 Phone: 815-221-1330 |