| Digestive Disease Consultants Ltd | |
|
1302 Franklin Ave #4800 Normal IL 61761 | |
| (309) 454-5900 | |
| (309) 454-2820 |
| Full Name | Digestive Disease Consultants Ltd |
|---|---|
| Speciality | Internal Medicine |
| Location | 1302 Franklin Ave, Normal, Illinois |
| Authorized Official Name and Position | Jill Metz (OFFICE MANAGER) |
| Authorized Official Contact | 3094545900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Digestive Disease Consultants Ltd 1302 Franklin Ave #4800 Normal IL 61761 Ph: (309) 454-5900 | Digestive Disease Consultants Ltd 1302 Franklin Ave #4800 Normal IL 61761 Ph: (309) 454-5900 |
| NPI Number | 1306874102 |
|---|---|
| Provider Enumeration Date | 06/29/2006 |
| Last Update Date | 09/06/2007 |
| Medicare PECOS PAC ID | 0143216630 |
|---|---|
| Medicare Enrollment ID | O20040427000536 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306874102 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Kenneth R Schoenig |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1033147848 PECOS PAC ID: 2264483916 Enrollment ID: I20100730000605 |
| Provider Name | Vijay Laxmi Misra |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1164475877 PECOS PAC ID: 3971545823 Enrollment ID: I20110107000891 |
| Provider Name | Robert E Clark |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1033372727 PECOS PAC ID: 9537309711 Enrollment ID: I20130711000493 |
| Provider Name | Brooke L Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235686759 PECOS PAC ID: 5092093526 Enrollment ID: I20161103000368 |
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