| Mjm Family Medicine Sc | |
|
900 Main St Ste 500 Peoria IL 61602-5022 | |
| (309) 672-4470 | |
| (309) 672-4471 |
| Full Name | Mjm Family Medicine Sc |
|---|---|
| Speciality | Family Medicine |
| Location | 900 Main St Ste 500, Peoria, Illinois |
| Authorized Official Name and Position | Matthew J Mcmillin (PHYSICIAN/OWNER) |
| Authorized Official Contact | 3093393469 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mjm Family Medicine Sc 900 Main St Ste 500 Peoria IL 61602-5022 Ph: (309) 672-4470 | Mjm Family Medicine Sc 900 Main St Ste 500 Peoria IL 61602-5022 Ph: (309) 672-4470 |
| NPI Number | 1093412686 |
|---|---|
| Provider Enumeration Date | 02/14/2023 |
| Last Update Date | 02/14/2023 |
| Medicare PECOS PAC ID | 3274990528 |
|---|---|
| Medicare Enrollment ID | O20230601002059 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093412686 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Matthew J Mcmillin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528021987 PECOS PAC ID: 8426002718 Enrollment ID: I20050309000816 |
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