Organization
BUSHNELL FAMILY PRACTICE, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN ARNOLD M.D. (PRESIDENT)
(309) 772-9444
Entity
Organization
Contact information
Practice address
155 W HAIL ST, BUSHNELL, IL 61422-1346
(309) 772-9444
(309) 772-6446
Mailing address
PO BOX 446, MACOMB, IL 61455-0446
(309) 833-2868
(309) 836-3779
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036062336
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
014509
HEALTH ALLIANCE
IL
05
—
036062336
—
IL
01
—
148952
MEDICARE PART A
IL
01
—
5515957
BLUE CROSS BLUE SHIELD
IL
Enumeration date
01/09/2007
Last updated
11/03/2009
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