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Organization
LINCOLN TRAIL ORTHOPAEDIC CLINIC, S.C.
Active
Organization
LINCOLN TRAIL ORTHOPAEDIC CLINIC, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JULEE LEE (OFFICE MANAGER)
(217) 348-1052
Entity
Organization
Contact information
Practice address
103 PROFESSIONAL PLZ, MATTOON, IL 61938-9252
(217) 348-1030
(217) 348-1090
Mailing address
103 PROFESSIONAL PLZ, MATTOON, IL 61938-9252
(217) 348-1030
(217) 348-1090
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036058473
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002811
HEALTH ALLIANCE
IL
05
—
036058473
—
IL
01
—
133038
HEALTHLINK
IL
01
—
1515701
BLUE CROSS BLUE SHIELD
IL
01
—
791203439
RAILROAD MEDICARE
IL
Enumeration date
04/08/2008
Last updated
04/08/2008
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