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Organization

EAGLE FAMILY MEDICINE SC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ROBERT SCOTT BEVILL MD (PHYSICIAN/PRESIDENT)
(309) 446-3305
Entity
Organization

Contact information

Practice address
111 E KNOXVILLE ST, BRIMFIELD, IL 61517-8022
(309) 446-3305
(309) 446-9072
Mailing address
111 E KNOXVILLE ST, BRIMFIELD, IL 61517-8022
(309) 446-3305
(309) 446-9072

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
208745
MEDICARE GROUP NUMBER
IL
01
K37812
MEDICARE PROVIDER NUMBER
IL
Enumeration date
08/02/2005
Last updated
07/21/2022
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