| Danville Polyclinic, Ltd | |
|
707 N Logan Ave Danville IL 61832-4360 | |
| (217) 446-6410 | |
| (217) 477-4757 |
| Full Name | Danville Polyclinic, Ltd |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 707 N Logan Ave, Danville, Illinois |
| Authorized Official Name and Position | Melissa a Edington (ADMINISTRATOR) |
| Authorized Official Contact | 2174774750 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Danville Polyclinic, Ltd 707 N Logan Ave Danville IL 61832-4360 Ph: (217) 446-6410 | Danville Polyclinic, Ltd 707 N Logan Ave Danville IL 61832-4360 Ph: (217) 446-6410 |
| NPI Number | 1336181544 |
|---|---|
| Provider Enumeration Date | 06/12/2006 |
| Last Update Date | 11/25/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336181544 | NPI | - | NPPES |
| 100002020A | Medicaid | IN | |
| 221069 | Other | BLACK LUNG | |
| 09215807 | Other | IL | BCBS OF ILLINOIS |
| 1486765 | Other | UMWA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | 060000812 (Illinois) | Primary |
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