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310 E Tarrance Ave Pontiac IL 61764 | |
| (815) 844-7174 | |
| (815) 842-1063 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 310 E Tarrance Ave, Pontiac, Illinois |
| Authorized Official Name and Position | Malinda Lee Hillman (ADMINISTRATOR) |
| Authorized Official Contact | 8158447174 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 650 310 E Torrance Avenue Pontiac IL 61764 Ph: (815) 844-7174 | 310 E Tarrance Ave Pontiac IL 61764 Ph: (815) 844-7174 |
| NPI Number | 1255398517 |
|---|---|
| Provider Enumeration Date | 04/28/2006 |
| Last Update Date | 10/14/2011 |
| Medicare PECOS PAC ID | 5496796005 |
|---|---|
| Medicare Enrollment ID | O20111021000561 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255398517 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Primary |
| Provider Name | John M Rinker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316173636 PECOS PAC ID: 4082862750 Enrollment ID: I20120921000436 |
John W. Rinker Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1515 W Reynolds St, Pontiac, IL 61764 Phone: 815-842-3381 Fax: 815-842-2054 | |
Whole Body Medical Wellness Ltd Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 402 N Plum St, Pontiac, IL 61764 Phone: 815-844-4631 Fax: 815-844-1942 | |
J C Purnell Md Sc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 401 E Water Street, Pontiac, IL 61764 Phone: 815-842-1166 Fax: 815-844-5968 | |
Madison Street Clinic P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 520 W Madison St, Pontiac, IL 61764 Phone: 815-844-6106 Fax: 815-842-2526 |