Organization
POOLSIDE HEALTH & WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PATRICIA A OWENS (DIRECTOR OF PATIENT ACCOUNTING)
(217) 326-2911
Entity
Organization
Contact information
Practice address
3733 POOLSIDE DR, DANVILLE, IL 61832-1144
(217) 446-9283
(217) 442-2181
Mailing address
611 W PARK ST, URBANA, IL 61801-2500
(217) 326-2911
(217) 344-8047
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
13304532
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
075432
HAMP PROVIDER ID
IL
01
—
09232013
BLUE CROSS PROVIDER ID
—
01
—
515838
HEALTHLINK PROVIDER ID
IL
Enumeration date
01/02/2007
Last updated
08/22/2020
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