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912 W Seminary Ave Onarga IL 60955-1401 | |
(815) 268-4840 | |
(815) 268-4845 |
Full Name | |
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Speciality | Clinic/Center |
Location | 912 W Seminary Ave, Onarga, Illinois |
Authorized Official Name and Position | Matthew Ertel (CHIEF FINANCIAL OFFICER) |
Authorized Official Contact | 2177842601 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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912 W Seminary Ave Onarga IL 60955-1401 Ph: (815) 268-4840 | 912 W Seminary Ave Onarga IL 60955-1401 Ph: (815) 268-4840 |
NPI Number | 1972509701 |
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Provider Enumeration Date | 06/27/2005 |
Last Update Date | 07/21/2022 |
Medicare PECOS PAC ID | 5092703124 |
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Medicare Enrollment ID | O20100812000754 |
Identifier | Type | State | Issuer |
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1972509701 | NPI | - | NPPES |