| Milan Medical Group Ltd | |
|
1929 10th Ave E, Milan, IL 61264 | |
| (309) 787-2600 | |
| (309) 787-2643 |
| Full Name | Milan Medical Group Ltd |
|---|---|
| Type | Facility |
| Speciality | General Practice |
| Location | 1929 10th Ave E, Milan, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346362589 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | (* (Not Available)) | Secondary |
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Susan E Alden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629079280 PECOS PAC ID: 9335182468 Enrollment ID: I20051006000749 |
| Provider Name | Raymond A Burge |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1356340533 PECOS PAC ID: 9931091543 Enrollment ID: I20060301000557 |
| Provider Name | James E Petre |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619973989 PECOS PAC ID: 2668477290 Enrollment ID: I20061003000456 |
| Provider Name | Jeramy D Blackwood |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1174852016 PECOS PAC ID: 9931381738 Enrollment ID: I20110316000240 |
| Provider Name | Wayne B Davis |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1376716654 PECOS PAC ID: 4486724242 Enrollment ID: I20110426000166 |
| Provider Name | Jennifer Hook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033662044 PECOS PAC ID: 8729367008 Enrollment ID: I20161109000047 |
| Provider Name | Nicholas Ryan Petre |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699269308 PECOS PAC ID: 6709136625 Enrollment ID: I20210726000217 |
| Mailing Address | Practice Location Address |
|---|---|
| Milan Medical Group Ltd 1929 10th Ave E, Milan, IL 61264 Ph: (309) 787-2600 | Milan Medical Group Ltd 1929 10th Ave E, Milan, IL 61264 Ph: (309) 787-2600 |