| Spoon River Family Practice Center, Inc | |
|
45 E Side Sq Suite 102 Canton IL 61520-2671 | |
| (309) 647-9980 | |
| (309) 647-7792 |
| Full Name | Spoon River Family Practice Center, Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 45 E Side Sq, Canton, Illinois |
| Authorized Official Name and Position | Linda Kay Forestier (PRESIDENT) |
| Authorized Official Contact | 3096479980 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Spoon River Family Practice Center, Inc 45 E Side Sq Suite 102 Canton IL 61520-2671 Ph: (309) 647-9980 | Spoon River Family Practice Center, Inc 45 E Side Sq Suite 102 Canton IL 61520-2671 Ph: (309) 647-9980 |
| NPI Number | 1437268604 |
|---|---|
| Provider Enumeration Date | 08/30/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437268604 | NPI | - | NPPES |
| IL0101 | Other | IL | JOHN DEERE PROVIDER # |
| DA4719 | Other | MEDICARE RAILROAD GROUP # | |
| 0002932001 | Other | IL | BLUE CROSS PROVIDER # |
| 014152 | Other | IL | HEALTH ALLIANCE PROVDIER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Illinois) | Primary |
Graham Hospital Association Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 126 N 5th Ave, Canton, IL 61520 Phone: 309-647-0201 | |
Graham Hospital Association Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 126 N 5th Ave, Canton, IL 61520 Phone: 309-647-0201 | |
Graham Hospital Association Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 180 S Main St, Canton, IL 61520 Phone: 309-647-0201 Fax: 309-649-5302 | |
Fulton County Health Department Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 700 East Oak Street, Canton, IL 61520 Phone: 309-647-1134 Fax: 309-647-9545 | |
Graham Services Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 175 S Main St, Canton, IL 61520 Phone: 309-647-0201 Fax: 309-647-0201 |