Organization
PRAIRIE DIAGNOSTIC CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FRANK L. MIKELL M.D. (PRESIDENT)
(217) 788-0706
Entity
Organization
Contact information
Practice address
401 E. CARPENTER ST., SPRINGFIELD, IL 62702
(217) 788-0706
(217) 788-0848
Mailing address
619 E MASON ST, SPRINGFIELD, IL 62701-1034
(217) 788-0706
(217) 788-0848
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Enumeration date
05/23/2006
Last updated
08/22/2020
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