Organization
CARLE CLINIC ASSOCATION, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RENITA JACKSON (DIRECTOR, FINANCIAL SERVICES)
(217) 326-8210
Entity
Organization
Contact information
Practice address
602 W UNIVERSITY AVE, URBANA, IL 61801-2530
(217) 383-4636
Mailing address
602 W UNIVERSITY AVE, URBANA, IL 61801-2530
(217) 383-4636
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
—
—
207L00000X
Anesthesiology Physician
—
—
207LA0401X
Addiction Medicine (Anesthesiology) Physician
—
—
207LC0200X
Critical Care Medicine (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
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207RG0100X
Gastroenterology Physician
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
207RH0003X
Hematology & Oncology Physician
—
—
207RI0001X
Clinical & Laboratory Immunology (Internal Medicine) Physician
—
—
Other
Enumeration date
05/09/2006
Last updated
05/13/2008
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