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DANVILLE POLYCLINIC LTD NPI 1336181544


NPI Information

NPI: 1336181544
Provider Name: DANVILLE POLYCLINIC, LTD
Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

Address:
707 N LOGAN AVE
DANVILLE, IL
ZIP 61832
Phone: (217) 446-6410
Get Directions

DANVILLE POLYCLINIC, LTD is a multi-specialty clinic center in Danville, IL. DANVILLE POLYCLINIC, LTD NPI is 1336181544. The provider is registered as an organization entity type.

The provider's business location address is:

707 N LOGAN AVE
DANVILLE, IL
ZIP 61832-360
Phone: (217) 446-6410
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) 477-4750.

The enumeration date for this NPI number is 6/12/2006 and was last updated on 11/25/2008.


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
1261QM1300XClinic/CenterMulti-Specialty060000812ILLINOISYes

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
1100002020AMEDICAIDINDIANA
2=========OTHERHEALTH ALLIANCE
3224751MEDICARE ID-TYPE UNSPECIFIEDILLINOISILLINOIS MEDICARE
4C31019MEDICARE ID-TYPE UNSPECIFIEDILLINOISRAILROAD MEDICARE ILLINOI
5=========OTHERPHCS
6=========OTHERCIGNA
7=========001OTHERTRICARE/CHAMPUS
809215807OTHERILLINOISBCBS OF ILLINOIS
9=========OTHERPERSONAL CARE/COVENTRY
100354740001MEDICARE NSCILLINOIS
11=========OTHERBEECHSTREET
12221069OTHERBLACK LUNG
131486765OTHERUMWA
14=========OTHERUNITED HEALTHCARE
15=========OTHERHFN
16=========OTHERPREFERRED PLAN
17C14618MEDICARE ID-TYPE UNSPECIFIEDINDIANARAILROAD MEDICARE INDIANA

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
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