MID-ILLINOIS MEDICAL CARE ASSOCIATES LLC NPI 1477742831

NPI Information

  • NPI: 1477742831
  • Provider Name: MID-ILLINOIS MEDICAL CARE ASSOCIATES, LLC
  • Classification: Clinic/Center - 261QR1300X
  • Specialization: Rural Health
  • Entity Type: Organization
  • Doing Business As: RUNDE CLINIC
  • CLIA Number: 14D0434939
  • Address: 206 N PEARL
    TEUTOPOLIS, IL
    ZIP 62467
  • Phone: (217) 857-6481

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NPI Details

MID-ILLINOIS MEDICAL CARE ASSOCIATES, LLC is a rural health clinic center in Teutopolis, IL. MID-ILLINOIS MEDICAL CARE ASSOCIATES, LLC NPI is 1477742831. The provider is registered as an organization entity type.
The provider Is Doing Business As Runde Clinic.

The provider's business location address is:

206 N PEARL
TEUTOPOLIS, IL
ZIP 62467
Phone: (217) 857-6481
Fax: (217) 857-6094

The provider's authorized official is Eugene P. Dust .
The authorized official title is President Of Llc and has the following contact phone number (217) 347-5917.

The CLIA number assigned to this NPI record is 14D0434939 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/22/2007 and was last updated on 6/27/2017.

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
1261QR1300XClinic/CenterRural HealthYes

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
1148962MEDICARE OSCAR/CERTIFICATION
2=========004MEDICAIDILLINOIS

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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