| Sa Belvidere Clinic | |
|
1700 Henry Luckow Ln Belvidere IL 61008 | |
| (779) 696-8650 | |
| Not Available |
| Full Name | Sa Belvidere Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 1700 Henry Luckow Ln, Belvidere, Illinois |
| Authorized Official Name and Position | Don Daniels (VP) |
| Authorized Official Contact | 8159662084 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sa Belvidere Clinic Po Box 78866 Milwaukee WI 53278-8866 Ph: () - | Sa Belvidere Clinic 1700 Henry Luckow Ln Belvidere IL 61008 Ph: (779) 696-8650 |
| NPI Number | 1417018110 |
|---|---|
| Provider Enumeration Date | 12/13/2006 |
| Last Update Date | 07/12/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417018110 | NPI | - | NPPES |
| 14D0875979 | Other | IL | CLIA |
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