Organization
RANCHERO CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BERNIE C RANCHERO MD (PRESIDENT)
(630) 696-0714
Entity
Organization
Contact information
Practice address
825 18TH ST STE 238, CHARLESTON, IL 61920-2940
(630) 696-0714
Mailing address
1034 W POLK AVE, CHARLESTON, IL 61920-1709
(630) 696-0714
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1568656445
NPI
—
Enumeration date
06/06/2025
Last updated
06/06/2025
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