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CARLE CLINIC ASSOCIATION PC NPI 1164552113


NPI Information

NPI: 1164552113
Provider Name: CARLE CLINIC ASSOCIATION, PC
Classification: Durable Medical Equipment & Medical Supplies - 332B00000X
Entity Type: Organization
Address:
1813 W KIRBY AVE
CHAMPAIGN, IL
ZIP 61821
Phone: (217) 326-1220
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CARLE CLINIC ASSOCIATION, PC is a durable medical equipment medical supplies in Champaign, IL. The provider is a supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time. CARLE CLINIC ASSOCIATION, PC NPI is 1164552113. The provider is registered as an organization entity type.

The provider's business location address is:

1813 W KIRBY AVE
CHAMPAIGN, IL
ZIP 61821-410
Phone: (217) 326-1220

The provider's authorized official is Kirk Moberg .
The authorized official title is Senior Vice President and has the following contact phone number (217) 383-3311.

The enumeration date for this NPI number is 3/7/2007 and was last updated on 12/30/2010.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1332B00000XDurable Medical Equipment & Medical Supplies060009054ILLINOISYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10533210001MEDICARE NSCILLINOIS
2754210, 407270MEDICARE ID-TYPE UNSPECIFIEDILLINOIS

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: 4/28/2024

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