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815 N Orlando Smith St Oglesby IL 61348-9692 | |
(815) 224-0896 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Primary Care |
Location | 815 N Orlando Smith St, Oglesby, Illinois |
Authorized Official Name and Position | Dori Bonnell (DIRECTOR OF PHYSICIAN PRACTICES) |
Authorized Official Contact | 8157803222 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1305 6th St Peru IL 61354-2759 Ph: (815) 223-3300 | 815 N Orlando Smith St Oglesby IL 61348-9692 Ph: (815) 224-0896 |
NPI Number | 1114299583 |
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Provider Enumeration Date | 02/01/2012 |
Last Update Date | 01/28/2021 |
Identifier | Type | State | Issuer |
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1114299583 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Mendota Community Hospital Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 790 W Walnut St, Oglesby, IL 61348 Phone: 815-221-1330 |