# CARLINVILLE MEDICAL CLINIC, INC.

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

## Provider details

- **NPI number:** 1730213026
- **Authorized official:** MARGIE BUSBY (OFFICE & BILLING MANAGER)
- **Authorized official phone:** (217) 854-9411

## Contact information

- **Practice address:** 604 N. BROAD, CARLINVILLE, IL 62626
- **Practice address phone:** (217) 854-9411
- **Practice address fax:** (217) 854-2858
- **Mailing address:** 604 N. BROAD, CARLINVILLE, IL 62626
- **Mailing address phone:** (217) 854-9411
- **Mailing address fax:** (217) 854-2858

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 036057724 | IL | — |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |
| 363LF0000X | Family Nurse Practitioner | 209000907 | IL | — |

## Other

- **Enumeration date:** 03/16/2007
- **Last updated:** 12/02/2024