Organization
HEALTHCARE NETWORK ASSOCIATES OF SANGAMON, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT T CLARKE (PRESIDENT AND CEO)
(217) 788-3340
Entity
Organization
Contact information
Practice address
701 N 1ST ST, SPRINGFIELD, IL 62781-0001
(217) 757-7491
(217) 757-2021
Mailing address
PO BOX 3428, SPRINGFIELD, IL 62708-3428
(217) 757-7491
(217) 757-2021
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
797350
MEDICARE N.P. GROUP
IL
01
—
CE7885
RAILROAD MEDICARE GROUP
IL
01
—
CE8722
RAILROAD MEDICARE GROUP
IL
01
—
CE9939
RAILROAD GROUP NUMBER
IL
01
—
CG1144
RAILROAD MEDICARE GROUP
IL
Enumeration date
02/08/2006
Last updated
04/14/2008
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