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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
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