| Provena Medical Group | |
|
405 Sheridan St Danville IL 61832-4451 | |
| (217) 431-6330 | |
| Not Available |
| Full Name | Provena Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 405 Sheridan St, Danville, Illinois |
| Authorized Official Name and Position | Daniel Boland (FINANCIAL REPORTING SPECIALIST) |
| Authorized Official Contact | 8158063111 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Provena Medical Group 9223 W Saint Francis Rd Frankfort IL 60423-8330 Ph: (815) 806-3111 | Provena Medical Group 405 Sheridan St Danville IL 61832-4451 Ph: (217) 431-6330 |
| NPI Number | 1134314602 |
|---|---|
| Provider Enumeration Date | 09/07/2007 |
| Last Update Date | 04/20/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134314602 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Illinois) | Primary |
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