Organization
PEDIATRIC PROVIDERS OF DANVILLE, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HOLLY MAE MAES MD (PRESIDENT AND MEDICAL DIRECTOR)
(217) 442-0433
Entity
Organization
Contact information
Practice address
737 N LOGAN AVE, DANVILLE, IL 61832-4363
(217) 442-0433
(217) 442-0485
Mailing address
737 N LOGAN AVE, DANVILLE, IL 61832-4363
(217) 442-0433
(217) 442-0485
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
036113601
IL
Other
Enumeration date
04/18/2012
Last updated
07/01/2013
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