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Organization
SPORTS MEDICINE CLINIC OF MACON COUNTY
Active
Organization
SPORTS MEDICINE CLINIC OF MACON COUNTY
Active
Other names
Hills' Sports Medicine & Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MISS ROBERT W HILL ATC (OWNER, CEO)
(217) 428-6222
Entity
Organization
Contact information
Practice address
1900 E LAKE SHORE DR, SUITE 150, DECATUR, IL 62521-3824
(217) 428-6222
(217) 428-2617
Mailing address
1900 E LAKE SHORE DR, SUITE 150, DECATUR, IL 62521-3824
(217) 428-6222
(217) 428-2617
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5815203
BLUE CROSS BLUE SHIELD
IL
Enumeration date
01/31/2006
Last updated
08/22/2020
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