| Mid-central Ill Gast Ltd | |
|
2200 Jacobssen Dr Suite B Normal IL 61761-5516 | |
| (309) 451-1123 | |
| (309) 451-1212 |
| Full Name | Mid-central Ill Gast Ltd |
|---|---|
| Speciality | Internal Medicine - Gastroenterology |
| Location | 2200 Jacobssen Dr, Normal, Illinois |
| Authorized Official Name and Position | Stephen S Matter (PRESIDENT) |
| Authorized Official Contact | 3094511123 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mid-central Ill Gast Ltd 2200 Jacobssen Dr Suite B Normal IL 61761-5516 Ph: (309) 451-1123 | Mid-central Ill Gast Ltd 2200 Jacobssen Dr Suite B Normal IL 61761-5516 Ph: (309) 451-1123 |
| NPI Number | 1992845358 |
|---|---|
| Provider Enumeration Date | 02/07/2007 |
| Last Update Date | 08/28/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992845358 | NPI | - | NPPES |
| 0360818161 | Medicaid | IL | |
| 05725403 | Other | IL | BLUECROSS BLUESHIELD |
| 0360788251 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | () | Primary |
Pentus Health Wylie LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 448 Wylie Dr, Normal, IL 61761 Phone: 844-973-6887 |
Bromenn Family Health Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1300 Franklin Ave Ste 100, Normal, IL 61761 Phone: 309-454-1400 |
Pentus Health Wylie Limited Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 448 Wylie Dr, Normal, IL 61761 Phone: 844-973-6887 |
Johnson Chiropractic, SC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 310 Susan Dr, Suite 2, Normal, IL 61761 Phone: 309-808-1123 Fax: 309-808-1516 |
Ambulatory Medical Associates LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2010 Jacobssen Dr, Normal, IL 61761 Phone: 309-452-0995 Fax: 309-862-0961 |
Digestive Disease Consultants Ltd Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1302 Franklin Ave, #4800, Normal, IL 61761 Phone: 309-454-5900 Fax: 309-454-2820 |