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Organization
CHAMPAIGN INTEGRATIVE CLINIC, PLLC
Active
Organization
CHAMPAIGN INTEGRATIVE CLINIC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TED NEMECZ (CFO)
(217) 637-5171
Entity
Organization
Contact information
Practice address
3115 VILLAGE OFFICE PL, CHAMPAIGN, IL 61822-7673
(217) 531-4101
Mailing address
3115 VILLAGE OFFICE PL, CHAMPAIGN, IL 61822-7673
(217) 531-4101
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
363L00000X
Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/03/2026
Last updated
04/03/2026
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