Organization
MEDICAL INCOME MANAGEMENT CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KURT M DEARNBARGER MD (OWNER)
(217) 728-9999
Entity
Organization
Contact information
Practice address
101 W JEFFERSON ST, SULLIVAN, IL 61951-1914
(217) 728-9999
Mailing address
PO BOX 1215, MATTOON, IL 61938-1215
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036092940
—
IL
01
—
P00151494
RAILROAD MEDICARE PALMETTO GBA
IL
01
—
P00329285
RETIRED RAILROAD
—
Enumeration date
07/17/2006
Last updated
04/24/2009
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