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227 N Market St Paxton IL 60957-1123 | |
(217) 379-4864 | |
(217) 379-6494 |
Full Name | |
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Speciality | Clinic/Center |
Location | 227 N Market St, Paxton, 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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227 N Market St Paxton IL 60957-1123 Ph: (217) 379-4864 | 227 N Market St Paxton IL 60957-1123 Ph: (217) 379-4864 |
NPI Number | 1992700595 |
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Provider Enumeration Date | 06/20/2005 |
Last Update Date | 07/21/2022 |
Medicare PECOS PAC ID | 5092703124 |
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Medicare Enrollment ID | O20100831000621 |
Identifier | Type | State | Issuer |
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1992700595 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | 006 (Illinois) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |