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CC MEDICAL CLINIC SC NPI 1952427163


NPI Information

NPI: 1952427163
Provider Name: CC MEDICAL CLINIC SC
Classification: Obstetrics & Gynecology - 207VX0000X
Entity Type: Organization

Specialization: Obstetrics

Address:
1141 N CHENEY ST
TAYLORVILLE, IL
ZIP 62568
Phone: (217) 287-7477
Get Directions

CC MEDICAL CLINIC SC is an obstetrics obstetrics gynecology in Taylorville, IL. The provider is a physician who specializes in diagnosis, treatment, and management of patients with obstetric conditions. Source: National Uniform Claim Committee CC MEDICAL CLINIC SC NPI is 1952427163. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1141 N CHENEY ST
TAYLORVILLE, IL
ZIP 62568-741
Phone: (217) 287-7477
Fax: (217) 287-7511

The provider's authorized official is Hwa-long Chen .
The authorized official title is President and has the following contact phone number (217) 287-7477.

The enumeration date for this NPI number is 3/21/2007 and was last updated on 10/26/2015.


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
1207VX0000XObstetrics & GynecologyObstetrics036-049201ILLINOISYes

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=========002MEDICAIDILLINOIS
2D89416MEDICARE UPINILLINOIS
31126922MEDICARE PINILLINOIS
4148921MEDICARE PINILLINOIS
5148921MEDICARE OSCAR/CERTIFICATIONILLINOIS

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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