| Pediatric Providers Of Danville, Ltd | |
|
737 N Logan Ave Danville IL 61832-4363 | |
| (217) 442-0433 | |
| (217) 442-0485 |
| Full Name | Pediatric Providers Of Danville, Ltd |
|---|---|
| Speciality | Clinic/center |
| Location | 737 N Logan Ave, Danville, Illinois |
| Authorized Official Name and Position | Holly Mae Maes (PRESIDENT AND MEDICAL DIRECTOR) |
| Authorized Official Contact | 2174420433 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric Providers Of Danville, Ltd 737 N Logan Ave Danville IL 61832-4363 Ph: (217) 442-0433 | Pediatric Providers Of Danville, Ltd 737 N Logan Ave Danville IL 61832-4363 Ph: (217) 442-0433 |
| NPI Number | 1659638401 |
|---|---|
| Provider Enumeration Date | 04/18/2012 |
| Last Update Date | 07/01/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659638401 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 036113601 (Illinois) | Primary |
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