| Promise Healthcare Nfp | |
|
821 S Neil St Champaign IL 61820-5205 | |
| (217) 356-1558 | |
| Not Available |
| Full Name | Promise Healthcare Nfp |
|---|---|
| Speciality | Clinic/Center |
| Location | 821 S Neil St, Champaign, Illinois |
| Authorized Official Name and Position | April Arrasmith (BILLING MANAGER) |
| Authorized Official Contact | 2174035403 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Promise Healthcare Nfp 819 Bloomington Rd Champaign IL 61820-2101 Ph: (217) 356-1558 | Promise Healthcare Nfp 821 S Neil St Champaign IL 61820-5205 Ph: (217) 356-1558 |
| NPI Number | 1043936438 |
|---|---|
| Provider Enumeration Date | 10/17/2022 |
| Last Update Date | 10/17/2022 |
| Medicare PECOS PAC ID | 6103071345 |
|---|---|
| Medicare Enrollment ID | O20221229001383 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043936438 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
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