# MID-ILLINOIS MEDICAL CARE ASSOCIATES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MID-ILLINOIS MEDICAL CARE ASSOCIATES, LLC
- **Other names:** Dieterich Community Medical Center
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1568619088
- **Legal business name:** MID-ILLINOIS MEDICAL CARE ASSOCIATES, LLC
- **Authorized official:** DR. EUGENE P. DUST M.D. (PRESIDENT OF MID-ILLINOIS MEDICAL C)
- **Authorized official phone:** (217) 347-2707

## Contact information

- **Practice address:** 203 S. MAIN ST., DIETERICH, IL 62424
- **Practice address phone:** (217) 925-5730
- **Practice address fax:** (217) 925-5736
- **Mailing address:** 1207 NETWORK CENTRE DR, SUITE 3, EFFINGHAM, IL 62401-4632
- **Mailing address phone:** (217) 347-2707
- **Mailing address fax:** (217) 347-2827

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | 036120332 | IL | Yes |

## Other

- **Enumeration date:** 08/27/2008
- **Last updated:** 06/27/2017