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Organization

CARLE CLINIC ASSOCIATION, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KIRK MOBERG MD, PHD (SENIOR VICE PRESIDENT)
(217) 337-4105
Entity
Organization

Contact information

Practice address
1818 E WINDSOR RD, URBANA, IL 61802-9566
(217) 255-9636
Mailing address
1818 E WINDSOR RD, URBANA, IL 61802-9566
(217) 255-9636

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
060009889
IL

Other

Enumeration date
10/14/2008
Last updated
10/14/2008
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