Organization
CARLINVILLE MEDICAL CLINIC, INC.
Active
Parent organization
CARLINVILLE MEDICAL CLINIC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CARLINVILLE MEDICAL CLINIC
Authorized official
MRS. MARGIE BUSBY (OFFICE MANAGER)
(217) 854-9411
Entity
Organization
Contact information
Practice address
604 N BROAD ST, CARLINVILLE, IL 62626-1021
(217) 854-9411
(217) 854-2858
Mailing address
604 N BROAD, CARLINVILLE, IL 62626-1608
(217) 854-9411
(217) 854-2858
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036057724
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5930138
BLUE CROSS/BLUE SHIELD
IL
Enumeration date
05/05/2010
Last updated
08/08/2022
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