Organization
CENTRAL ILLINOIS FAMILY HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KELLI LYNN BLAGG APN (APN OWNER)
(217) 235-4227
Entity
Organization
Contact information
Practice address
10555 EAST COUNTY RD 800 NORTH, MATTOON, IL 61938
(217) 235-4227
(217) 235-4274
Mailing address
10555 EAST COUNTY RD 800 NORTH, MATTOON, IL 61938
(217) 235-4227
(217) 235-4274
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
IL
Other
Enumeration date
11/14/2007
Last updated
01/23/2008
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