Organization
CARLINVILLE MEDICAL CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARGIE BUSBY (OFFICE & BILLING MANAGER)
(217) 854-9411
Entity
Organization
Contact information
Practice address
604 N. BROAD, CARLINVILLE, IL 62626
(217) 854-9411
(217) 854-2858
Mailing address
604 N. BROAD, CARLINVILLE, IL 62626
(217) 854-9411
(217) 854-2858
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036057724
IL
261QR1300X
Rural Health Clinic/Center
Primary
—
—
363LF0000X
Family Nurse Practitioner
209000907
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036057724
—
IL
Enumeration date
03/16/2007
Last updated
12/02/2024
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