| Board Of Trustees Of The University Of Illinois | |
|
405 Charles St Mt Morris IL 61054-1646 | |
| (815) 734-6061 | |
| (815) 734-7033 |
| Full Name | Board Of Trustees Of The University Of Illinois |
|---|---|
| Speciality | Family Medicine |
| Location | 405 Charles St, Mt Morris, Illinois |
| Authorized Official Name and Position | John Fitzhorn (DIRECTOR OF PATIENT ACCOUNTS) |
| Authorized Official Contact | 8153955892 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Board Of Trustees Of The University Of Illinois 1601 Parkview Ave S300 Rockford IL 61107-1822 Ph: (815) 395-5892 | Board Of Trustees Of The University Of Illinois 405 Charles St Mt Morris IL 61054-1646 Ph: (815) 734-6061 |
| NPI Number | 1033157755 |
|---|---|
| Provider Enumeration Date | 06/03/2006 |
| Last Update Date | 09/10/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033157755 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |