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9951 Rock Cut Xing Loves Park IL 61111-1999 | |
(815) 639-8500 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 9951 Rock Cut Xing, Loves Park, Illinois |
Authorized Official Name and Position | Robert C Sehring (CEO) |
Authorized Official Contact | 3096552850 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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124 Sw Adams St Peoria IL 61602-1308 Ph: (309) 655-2850 | 9951 Rock Cut Xing Loves Park IL 61111-1999 Ph: (815) 639-8500 |
NPI Number | 1558067975 |
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Provider Enumeration Date | 02/07/2023 |
Last Update Date | 03/07/2024 |
Medicare PECOS PAC ID | 5496654006 |
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Medicare Enrollment ID | O20230613002434 |
Identifier | Type | State | Issuer |
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1558067975 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Swedishamerican Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 Heart Blvd, Loves Park, IL 61111 Phone: 779-696-4400 Fax: 779-696-3995 | |
Medical Resource Center Ltd Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6550 E Riverside Blvd, Loves Park, IL 61111 Phone: 815-633-4100 Fax: 815-633-5141 | |