| |
300 N Maple St Effingham IL 62401-2003 | |
(217) 342-4151 | |
(217) 342-4190 |
Full Name | |
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Speciality | Clinic/Center |
Location | 300 N Maple St, Effingham, Illinois |
Authorized Official Name and Position | Alan Nerone (SENIOR VICE PRESIDENT & CFO) |
Authorized Official Contact | 2175287541 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1025 S 6th St Springfield IL 62703-2403 Ph: (217) 528-7541 | 300 N Maple St Effingham IL 62401-2003 Ph: (217) 342-4151 |
NPI Number | 1205023637 |
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Provider Enumeration Date | 10/01/2007 |
Last Update Date | 03/22/2019 |
Medicare PECOS PAC ID | 0547166076 |
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Medicare Enrollment ID | O20160222002437 |
Identifier | Type | State | Issuer |
---|---|---|---|
1205023637 | NPI | - | NPPES |
371329873002 | Medicaid | IL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (Illinois) | Primary |
Paul D. Oltman, M.d., S.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 900 W Temple Ave, Suite 204, Effingham, IL 62401 Phone: 217-347-7776 Fax: 217-347-7526 | |
Baggett Chiropractic Care, Ltd. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 801 W Fayette Ave, Effingham, IL 62401 Phone: 217-342-9700 Fax: 217-342-9710 | |
Cep America-illinois Hospitalists, Llp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 503 N Maple St, Effingham, IL 62401 Phone: 217-347-1211 | |