MILAN MEDICAL GROUP LTD NPI 1346362589

NPI Information

NPI: 1346362589
Provider Name: MILAN MEDICAL GROUP, LTD

Former Legal Business Name: COAL VALLEY MEDICAL CENTER

Classification: General Practice - 208D00000X
Entity Type: Organization

Address:
1929 10TH AVE E
MILAN, IL
ZIP 61264
Phone: (309) 787-2600
Get Directions

MILAN MEDICAL GROUP, LTD is a general practice in Milan, IL. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee MILAN MEDICAL GROUP, LTD NPI is 1346362589. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Coal Valley Medical Center.

The provider's business location address is:

1929 10TH AVE E
MILAN, IL
ZIP 61264-953
Phone: (309) 787-2600
Fax: (309) 787-2643

The provider's authorized official is Raymond A Burge .
The authorized official title is Owner and has the following contact phone number (309) 787-2600.

The CLIA number assigned to this NPI record is 14D1049387 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/6/2007 and was last updated on 9/20/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	111N00000X	Chiropractor				No
2	225100000X	Physical Therapist		070014182	ILLINOIS	No
3	261QH0100X	Clinic/Center	Health Service			No
4	363LF0000X	Nurse Practitioner	Family	041171677	ILLINOIS	No
5	208D00000X	General Practice		036113072	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	209030400	OTHER	ILLINOIS	DEPARTMENT OF LABOR ID
2	8132027	OTHER	ILLINOIS	BLUE SHIELD FACILITY ID

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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