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Organization

FAMILY PRACTICE MEDICAL CENTER LTD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GEORGE R GINDI MD (OWNER)
(217) 431-2025
Entity
Organization

Contact information

Practice address
511 W FAIRCHILD ST, DANVILLE, IL 61832-3801
(217) 431-2025
(217) 431-0014
Mailing address
511 W FAIRCHILD ST, DANVILLE, IL 61832-3801
(217) 431-2025
(217) 431-0014

Taxonomy

Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
036087566
IL
261QR1300X
Rural Health Clinic/Center
036100736
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
015566
HEALTH ALLIANCE
IL
05
036087566
IL
05
036100736
IL
01
09232019
BLUE CROSS BLUE SHIELD
IL
Enumeration date
06/09/2006
Last updated
04/25/2013
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