|
| |
|
1506 W Reynolds St Pontiac IL 61764-9674 | |
| (815) 844-6123 | |
| (309) 655-4878 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 1506 W Reynolds St, Pontiac, Illinois |
| Authorized Official Name and Position | Robert Carl Sehring (CEO, OSF HEALTHCARE SYSTEM) |
| Authorized Official Contact | 3096557804 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
124 Sw Adams St Peoria IL 61602-1308 Ph: (309) 655-2850 | 1506 W Reynolds St Pontiac IL 61764-9674 Ph: (815) 844-6123 |
| NPI Number | 1245955608 |
|---|---|
| Provider Enumeration Date | 10/07/2022 |
| Last Update Date | 12/13/2024 |
| Medicare PECOS PAC ID | 0648187252 |
|---|---|
| Medicare Enrollment ID | O20221108002152 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245955608 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
John W. Rinker Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1515 W Reynolds St, Pontiac, IL 61764 Phone: 815-842-3381 Fax: 815-842-2054 | |
Whole Body Medical Wellness Ltd Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 402 N Plum St, Pontiac, IL 61764 Phone: 815-844-4631 Fax: 815-844-1942 | |
J C Purnell Md Sc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 401 E Water Street, Pontiac, IL 61764 Phone: 815-842-1166 Fax: 815-844-5968 | |
Madison Street Clinic P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 520 W Madison St, Pontiac, IL 61764 Phone: 815-844-6106 Fax: 815-842-2526 |