| Rejuv Champaign Pc | |
|
606 North County Fair Drive A Champaign IL 61820 | |
| (217) 607-0762 | |
| Not Available |
| Full Name | Rejuv Champaign Pc |
|---|---|
| Speciality | Clinic/center |
| Location | 606 North County Fair Drive, Champaign, Illinois |
| Authorized Official Name and Position | Shawn Christopher Snider (OWNER) |
| Authorized Official Contact | 3096784243 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rejuv Champaign Pc 405 N Hershey Rd Bloomington IL 61704-3527 Ph: (309) 662-3002 | Rejuv Champaign Pc 606 North County Fair Drive A Champaign IL 61820 Ph: (217) 607-0762 |
| NPI Number | 1356601629 |
|---|---|
| Provider Enumeration Date | 05/21/2012 |
| Last Update Date | 05/21/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356601629 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 209005824 (Illinois) | Primary |
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