Organization
MIDWEST NEUROLOGY ASSOCIATES, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAURA J SCHLAGEL M.D. (PRESIDENT)
(217) 872-7000
Entity
Organization
Contact information
Practice address
302 W HAY ST, SUITE LL110, DECATUR, IL 62526-4167
(217) 872-7000
(217) 872-0417
Mailing address
302 W HAY ST, SUITE LL110, DECATUR, IL 62526-4167
(217) 872-7000
(217) 872-0417
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05820717
BLUE CROSS BLUE SHIELD
IL
01
—
CN7769
MEDICARE RAILROAD
IL
Enumeration date
03/14/2007
Last updated
10/25/2007
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