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106 S 1st St Fairbury IL 61739-1509 | |
(815) 692-2308 | |
(815) 692-3278 |
Full Name | |
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Speciality | Clinic/Center |
Location | 106 S 1st St, Fairbury, Illinois |
Authorized Official Name and Position | Robert C Sehring (CEO, OSF HEALTHCARE SYSTEM) |
Authorized Official Contact | 3096552850 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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124 Sw Adams St Peoria IL 61602-1308 Ph: (309) 655-2850 | 106 S 1st St Fairbury IL 61739-1509 Ph: (815) 692-2308 |
NPI Number | 1912622374 |
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Provider Enumeration Date | 10/07/2022 |
Last Update Date | 07/31/2024 |
Medicare PECOS PAC ID | 0648187252 |
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Medicare Enrollment ID | O20221116000037 |
Identifier | Type | State | Issuer |
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1912622374 | NPI | - | NPPES |
025 | Medicaid | IL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |