Organization
CARLE HEALTH CARE INCORPORATED
Active
Other names
Carle Physician Group
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN SNYDER (COO)
(217) 383-3329
Entity
Organization
Contact information
Practice address
611 W PARK ST, URBANA, IL 61801-2529
(217) 383-8300
Mailing address
611 W PARK ST, BWPC, URBANA, IL 61801-2529
(217) 383-6792
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
—
—
207L00000X
Anesthesiology Physician
—
—
207N00000X
Dermatology Physician
—
—
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
—
207RG0100X
Gastroenterology Physician
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
207RI0001X
Clinical & Laboratory Immunology (Internal Medicine) Physician
—
—
207RN0300X
Nephrology Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
207RX0202X
Medical Oncology Physician
—
—
208C00000X
Colon & Rectal Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DQ3650
MEDICARE RR
IL
Enumeration date
02/04/2010
Last updated
09/02/2015
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