Organization
DEPARTMENT OF VETERANS AFFAIRS
Active
Organization
DEPARTMENT OF VETERANS AFFAIRS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBIE TABELS (CREDENTIALING & PRIVILEGING)
(217) 554-5383
Entity
Organization
Contact information
Practice address
3035 E MOUND RD, DECATUR, IL 62526-9650
(217) 875-2670
Mailing address
3035 E MOUND RD, DECATUR, IL 62526-9650
(217) 875-2670
Taxonomy
Speciality
Code
Description
License number
State
261QV0200X
VA Clinic/Center
Primary
164000383
IL
Other
Enumeration date
07/10/2009
Last updated
07/10/2009
Update your record
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