Organization
BAYVIEW FAMILY CLINIC LTD
Active
Parent organization
BAYVIEW FAMILY CLINIC LTD
Other names
DANVILLE PEDIATRIC CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
BAYVIEW FAMILY CLINIC LTD
Authorized official
BAMIDELE EKUNSANMI MD (CEO)
(217) 336-3288
Entity
Organization
Contact information
Practice address
405 N. SHERIDAN ST., DANVILLE, IL 61832
(217) 446-3259
(217) 446-4132
Mailing address
206 BURWASH AVE, SAVOY, IL 61874-9510
(217) 356-3400
(217) 866-0122
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
036112430
IL
Other
Enumeration date
11/29/2012
Last updated
12/13/2023
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