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612 N 11th St Quincy IL 62301-2662 | |
(217) 224-9484 | |
(217) 224-7894 |
Full Name | |
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Speciality | Clinic/center - Rural Health |
Location | 612 N 11th St, Quincy, Illinois |
Authorized Official Name and Position | Nelson C Weichold (C.F.O.) |
Authorized Official Contact | 2175457578 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 19639 Springfield IL 62794-9639 Ph: (217) 545-7578 | 612 N 11th St Quincy IL 62301-2662 Ph: (217) 224-9484 |
NPI Number | 1609811520 |
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Provider Enumeration Date | 06/17/2006 |
Last Update Date | 12/03/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1609811520 | NPI | - | NPPES |
CB2589 | Other | IL | RR MEDICARE |
CE8687 | Other | IL | RR MEDICARE |
CE8689 | Other | IL | RR MEDICARE |
CE8686 | Other | IL | RR MEDICARE |
CE8931 | Other | IL | RR MEDICARE |
CE8688 | Other | IL | RR MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Blessing Walk-in Clinic Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3700 Broadway St, Quincy, IL 62305 Phone: 217-228-1060 | |
Board Of Trustees Of Southern Illinois University Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 205 S 24th St Ste 100, Quincy, IL 62301 Phone: 217-224-9484 Fax: 217-224-7950 |