DECATUR ATHLETIC CLUB NPI 1588892475

NPI Information

NPI: 1588892475
Provider Name: DECATUR ATHLETIC CLUB
Classification: Clinic/Center - 261QR0400X
Entity Type: Organization

Specialization: Rehabilitation

Address:
1010 W SOUTH SIDE DR
DECATUR, IL
ZIP 62521
Phone: (217) 423-7020
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DECATUR ATHLETIC CLUB is a rehabilitation clinic center in Decatur, IL. DECATUR ATHLETIC CLUB NPI is 1588892475. The provider is registered as an organization entity type.

The provider's business location address is:

1010 W SOUTH SIDE DR
DECATUR, IL
ZIP 62521-023
Phone: (217) 423-7020
Fax: (217) 423-7562

The provider's authorized official is Alice Yvonne Daniels .
The authorized official title is Director Of Post Rehabilitation and has the following contact phone number (217) 423-7020.

The enumeration date for this NPI number is 6/30/2009 and was last updated on 6/30/2009.

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	261QR0400X	Clinic/Center	Rehabilitation			Yes

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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