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322 N. Chicago Street Milford IL 60953-1409 | |
(217) 283-8540 | |
(217) 283-4062 |
Full Name | |
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Speciality | Clinic/Center |
Location | 322 N. Chicago Street, Milford, Illinois |
Authorized Official Name and Position | Harry Brockus (CEO) |
Authorized Official Contact | 2172838540 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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701 E Orange St Hoopeston IL 60942-1801 Ph: (217) 383-6792 | 322 N. Chicago Street Milford IL 60953-1409 Ph: (217) 283-8540 |
NPI Number | 1992059976 |
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Provider Enumeration Date | 10/30/2012 |
Last Update Date | 12/12/2013 |
Medicare PECOS PAC ID | 3577456037 |
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Medicare Enrollment ID | O20121221000021 |
Identifier | Type | State | Issuer |
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1992059976 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |