DANVILLE POLYCLINIC LTD NPI 1538101373

NPI Information

  • NPI: 1538101373
  • Provider Name: DANVILLE POLYCLINIC, LTD
  • Classification: Clinic/Center - 261QA1903X
  • Specialization: Ambulatory Surgical
  • Entity Type: Organization
  • Doing Business As: DANVILLE POLYCLINIC LTD ASTC
  • CLIA Number: 14D2165208
  • Address: 707 N LOGAN AVE
    DANVILLE, IL
    ZIP 61832
  • Phone: (217) 477-4794

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NPI Details

DANVILLE POLYCLINIC, LTD is an ambulatory surgical clinic center in Danville, IL. DANVILLE POLYCLINIC, LTD NPI is 1538101373. The provider is registered as an organization entity type.
The provider Is Doing Business As Danville Polyclinic Ltd Astc.

The provider's business location address is:

707 N LOGAN AVE
DANVILLE, IL
ZIP 61832-360
Phone: (217) 477-4794
Fax: (217) 477-4757

The provider's authorized official is Melissa A Edington .
The authorized official title is Administrator and has the following contact phone number (217) 477-4794.

The CLIA number assigned to this NPI record is 14D2165208 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Diagnostic exam of large bowel using a flexible endoscope (HCPCS:45378)
  • Removal of polyps or growths of large bowel using an endoscope with mechanical snare (HCPCS:45385)
  • Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope (HCPCS:43239)
  • Dilation of esophagus (HCPCS:43450)
  • Biopsy of large bowel using a flexible endoscope (HCPCS:45380)
  • Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope (HCPCS:43235)
  • Removal of central venous tube with port or pump (HCPCS:36590)

The enumeration date for this NPI number is 6/12/2006 and was last updated on 9/30/2008.

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
1261QA1903XClinic/CenterAmbulatory Surgical7002371ILLINOISYes

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
1200315840AMEDICAIDINDIANA
2167654OTHERPERSONAL CARE/COVENTRY
3141087MEDICARE ID-TYPE UNSPECIFIEDMEDICARE
4=========002OTHERTRICARE/CHAMPUS
51525OTHERILLINOISBCBS OF ILLINOIS
6490004989MEDICARE ID-TYPE UNSPECIFIEDRAILROAD MEDICARE
7=========006MEDICAIDILLINOIS

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: 3/30/2025

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