# DANVILLE POLYCLINIC, LTD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336181544
- **Authorized official:** MS. MELISSA A EDINGTON (ADMINISTRATOR)
- **Authorized official phone:** (217) 477-4750

## Contact information

- **Practice address:** 707 N LOGAN AVE, DANVILLE, IL 61832-4360
- **Practice address phone:** (217) 446-6410
- **Practice address fax:** (217) 477-4757
- **Mailing address:** 707 N LOGAN AVE, DANVILLE, IL 61832-4360
- **Mailing address phone:** (217) 446-6410
- **Mailing address fax:** (217) 477-4757

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | 060000812 | IL | Yes |

## Other

- **Enumeration date:** 06/12/2006
- **Last updated:** 11/25/2008