Full Name | |
---|---|
Speciality | Clinic/center - Rural Health |
Location | 3 Do It Drive, Altamont, Illinois |
Authorized Official Name and Position | Alan Nerone (CAO) |
Authorized Official Contact | 2175287541 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
1025 S 6th St Springfield IL 62703-2403 Ph: (217) 528-7541 | 3 Do It Drive Altamont IL 62411 Ph: (618) 483-6131 |
NPI Number | 1972823631 |
---|---|
Provider Enumeration Date | 06/04/2010 |
Last Update Date | 07/24/2017 |
Identifier | Type | State | Issuer |
---|---|---|---|
1972823631 | NPI | - | NPPES |
371329873005 | Medicaid | IL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |