Organization
DANVILLE PEDIATRIC CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT ELGHAMMER (M.D.)
(217) 446-3259
Entity
Organization
Contact information
Practice address
723 N LOGAN AVE, DANVILLE, IL 61832-4384
(217) 446-3259
Mailing address
723 N LOGAN AVE, DANVILLE, IL 61832-4384
(217) 446-3259
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
036-028934
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036028934
—
IL
Enumeration date
05/02/2008
Last updated
06/23/2008
Update your record
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