Organization
CENTRAL ILLINOIS FAMILY HEALTH CENTER
Active
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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