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Organization
MID-ILLINOIS MEDICAL CARE ASSOCIATES, LLC
Active
Organization
MID-ILLINOIS MEDICAL CARE ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EUGENE P. DUST M.D. (PRESIDENT)
(217) 347-2707
Entity
Organization
Contact information
Practice address
1207 NETWORK CENTRE DR, SUITE 3, EFFINGHAM, IL 62401-4632
(217) 347-2707
(217) 347-2827
Mailing address
1207 NETWORK CENTRE DR, SUITE 3, EFFINGHAM, IL 62401-4632
(217) 347-2707
(217) 347-2827
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2523247
BLUE CROSS BLUE SHIELD
IL
Enumeration date
03/23/2006
Last updated
08/01/2017
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