| Osf Healthcare - Medical Group - Roanoke | |
|
401 N Main St Roanoke IL 61561-7585 | |
| (309) 923-2661 | |
| Not Available |
| Full Name | Osf Healthcare - Medical Group - Roanoke |
|---|---|
| Speciality | Clinic/Center |
| Location | 401 N Main St, Roanoke, Illinois |
| Authorized Official Name and Position | Robert Carl Sehring (CEO) |
| Authorized Official Contact | 3096557689 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Osf Healthcare - Medical Group - Roanoke 124 Sw Adams St Peoria IL 61602-1308 Ph: () - | Osf Healthcare - Medical Group - Roanoke 401 N Main St Roanoke IL 61561-7585 Ph: (309) 923-2661 |
| NPI Number | 1164138848 |
|---|---|
| Provider Enumeration Date | 01/26/2023 |
| Last Update Date | 10/06/2023 |
| Medicare PECOS PAC ID | 0648187252 |
|---|---|
| Medicare Enrollment ID | O20230404001008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164138848 | NPI | - | NPPES |
| 999 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Carle Eureka Hospital Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 415 W Front St, Roanoke, IL 61561 Phone: 309-923-7456 Fax: 309-923-7839 |