| South Beloit Clinic | |
|
1701 Blackhawk Blvd South Beloit IL 61080-2407 | |
| (608) 364-1348 | |
| (608) 364-2338 |
| Full Name | South Beloit Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 1701 Blackhawk Blvd, South Beloit, Illinois |
| Authorized Official Name and Position | Ruth Gray (ASSISTANT ADMINISTRATOR) |
| Authorized Official Contact | 6083641348 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Beloit Clinic 1905 E Huebbe Pkwy Beloit WI 53511-1842 Ph: (608) 364-1348 | South Beloit Clinic 1701 Blackhawk Blvd South Beloit IL 61080-2407 Ph: (608) 364-1348 |
| NPI Number | 1346364718 |
|---|---|
| Provider Enumeration Date | 03/19/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346364718 | NPI | - | NPPES |
| 32069700 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Wisconsin) | Primary |
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