| OSF Healthcare - Medical Group - Princeton | |
|
530 Park Ave E Ste 303b Princeton IL 61356-3903 | |
| (815) 875-2811 | |
| Not Available |
| Full Name | OSF Healthcare - Medical Group - Princeton |
|---|---|
| Speciality | Clinic/Center |
| Location | 530 Park Ave E Ste 303b, Princeton, Illinois |
| Authorized Official Name and Position | Robert Carl Sehring (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 3096557689 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| OSF Healthcare - Medical Group - Princeton 124 Sw Adams St Peoria IL 61602-1308 Ph: (309) 655-2850 | OSF Healthcare - Medical Group - Princeton 530 Park Ave E Ste 303b Princeton IL 61356-3903 Ph: (815) 875-2811 |
| NPI Number | 1336997840 |
|---|---|
| Provider Enumeration Date | 05/09/2024 |
| Last Update Date | 05/09/2024 |
| Certification Date | 05/09/2024 |
| Medicare PECOS PAC ID | 4284541806 |
|---|---|
| Medicare Enrollment ID | O20240703002011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336997840 | NPI | - | NPPES |
| 999 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | () | Primary |
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