Organization
CARLE HEALTH CARE INCORPORATED
Active
Organization
CARLE HEALTH CARE INCORPORATED
Active
Other names
Carle Physician Group
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN SNYDER (VICE CHAIRMAN)
(217) 383-4604
Entity
Organization
Contact information
Practice address
602 W UNIVERSITY AVE, URBANA, IL 61801-2530
(217) 383-8300
Mailing address
611 W PARK ST, URBANA, IL 61801-2500
(217) 383-6792
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207QA0505X
Adult Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
208000000X
Pediatrics Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DQ3650
MEDICARE RR
IL
Enumeration date
04/01/2013
Last updated
04/01/2013
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