FAMILY PRACTICE MEDICAL CENTER LTD NPI 1659312072

NPI Information

NPI: 1659312072
Provider Name: FAMILY PRACTICE MEDICAL CENTER LTD
Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
511 W FAIRCHILD ST
DANVILLE, IL
ZIP 61832
Phone: (217) 431-2025
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FAMILY PRACTICE MEDICAL CENTER LTD is a rural health clinic center in Danville, IL. FAMILY PRACTICE MEDICAL CENTER LTD NPI is 1659312072. The provider is registered as an organization entity type.

The provider's business location address is:

511 W FAIRCHILD ST
DANVILLE, IL
ZIP 61832-801
Phone: (217) 431-2025
Fax: (217) 431-0014

The provider's authorized official is George R Gindi .
The authorized official title is Owner and has the following contact phone number (217) 431-2025.

The enumeration date for this NPI number is 6/9/2006 and was last updated on 4/25/2013.

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	261QR1300X	Clinic/Center	Rural Health	036100736	ILLINOIS	No
2	261QR1300X	Clinic/Center	Rural Health	036087566	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	09232019	OTHER	ILLINOIS	BLUE CROSS BLUE SHIELD
2	015566	OTHER	ILLINOIS	HEALTH ALLIANCE
3	E79195	MEDICARE UPIN	ILLINOIS
4	036100736	MEDICAID	ILLINOIS
5	=========001	MEDICAID	ILLINOIS
6	148935	MEDICARE OSCAR/CERTIFICATION	ILLINOIS
7	H18897	MEDICARE UPIN	ILLINOIS
8	036087566	MEDICAID	ILLINOIS
9	148956	MEDICARE OSCAR/CERTIFICATION	ILLINOIS
10	702130	MEDICARE PIN	ILLINOIS
11	=========002	MEDICAID	ILLINOIS

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

NPI Synchronization or Removal

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