Organization
NEW CENTURY PHYSICIANS OF WESTERN ILLINOIS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM A COLE JR. MD (CEO)
(800) 875-0136
Entity
Organization
Contact information
Practice address
695 N KELLOGG ST, GALESBURG, IL 61401-2807
(309) 343-8131
Mailing address
4750 HEMPSTEAD STATION DR, KETTERING, OH 45429-5164
(800) 875-0136
(937) 619-4231
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
1569417
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DE4420
RR MEDICARE GROUP #
—
Enumeration date
06/12/2006
Last updated
10/31/2007
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