| Western Illinois Home Provider Care Inc. | |
|
2 Industrial Park Rd Monmouth IL 61462-9698 | |
| (309) 734-9376 | |
| (309) 734-5338 |
| Full Name | Western Illinois Home Provider Care Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 2 Industrial Park Rd, Monmouth, Illinois |
| Authorized Official Name and Position | Amanda Newman (CEO) |
| Authorized Official Contact | 3097349376 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Western Illinois Home Provider Care Inc. 2 Industrial Park Rd Monmouth IL 61462-9698 Ph: (309) 734-9376 | Western Illinois Home Provider Care Inc. 2 Industrial Park Rd Monmouth IL 61462-9698 Ph: (309) 734-9376 |
| NPI Number | 1437925393 |
|---|---|
| Provider Enumeration Date | 11/30/2023 |
| Last Update Date | 02/23/2024 |
| Medicare PECOS PAC ID | 8729431762 |
|---|---|
| Medicare Enrollment ID | O20240126000348 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437925393 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Amanda Marie Kubis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134993967 PECOS PAC ID: 2264885201 Enrollment ID: I20240126000402 |
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