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Organization

CENTRAL ILLINOIS DIAGNOSTIC IMAGING CENTER, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. STEVEN SEIBERT D.M.D., MS (PRESIDENT)
(217) 398-4594
Entity
Organization

Contact information

Practice address
3002 CROSSING CT, CHAMPAIGN, IL 61822-6135
(217) 398-4594
Mailing address
1804 BENTBROOK DR, CHAMPAIGN, IL 61822-9218
(217) 352-2711

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
021001261
IL
261QR0200X
Radiology Clinic/Center
Primary
021001261
IL

Other

Enumeration date
08/27/2009
Last updated
10/25/2016
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