Organization
CARLE FOUNDATION PHYSICIAN SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES C LEONARD MD (CEO)
(217) 326-4677
Entity
Organization
Contact information
Practice address
401 N KELLER DR, SUITES 3 & 4, EFFINGHAM, IL 62401-1881
(217) 347-6400
Mailing address
602 W UNIVERSITY AVE, PROVIDER ENROLLMENT - NCW4, URBANA, IL 61801-2530
(217) 383-6792
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
02/01/2012
Last updated
05/08/2012
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