Spoon River Family Practice Center, Inc | |
45 E Side Sq Suite 102 Canton IL 61520-2671 | |
(309) 647-9980 | |
(309) 647-7792 |
Full Name | Spoon River Family Practice Center, Inc |
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Speciality | Family Medicine |
Location | 45 E Side Sq, Canton, Illinois |
Authorized Official Name and Position | Linda Kay Forestier (PRESIDENT) |
Authorized Official Contact | 3096479980 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Spoon River Family Practice Center, Inc 45 E Side Sq Suite 102 Canton IL 61520-2671 Ph: (309) 647-9980 | Spoon River Family Practice Center, Inc 45 E Side Sq Suite 102 Canton IL 61520-2671 Ph: (309) 647-9980 |
NPI Number | 1437268604 |
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Provider Enumeration Date | 08/30/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1437268604 | NPI | - | NPPES |
IL0101 | Other | IL | JOHN DEERE PROVIDER # |
DA4719 | Other | MEDICARE RAILROAD GROUP # | |
0002932001 | Other | IL | BLUE CROSS PROVIDER # |
014152 | Other | IL | HEALTH ALLIANCE PROVDIER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (Illinois) | Primary |