Organization
CARLE CLINIC ASSOCIATION, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIRK MOBERG (SENIOR VICE PRESIDENT)
(217) 383-3311
Entity
Organization
Contact information
Practice address
4000 GREEN APPLE LANE, MONTICELLO, IL 61856-1175
(217) 762-2518
Mailing address
4000 GREEN APPLE LANE, MONTICELLO, IL 61856-1175
(217) 762-2518
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
060009052
IL
Other
Enumeration date
03/07/2007
Last updated
09/04/2009
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