Organization
MARSHALL CLINIC EFFINGHAM, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HOPE E KNAUER M.D. (PRESIDENT)
(217) 342-4151
Entity
Organization
Contact information
Practice address
300 N MAPLE ST, EFFINGHAM, IL 62401-2003
(217) 342-4151
(217) 342-4190
Mailing address
300 N MAPLE ST, EFFINGHAM, IL 62401-2003
(217) 342-4151
(217) 342-4190
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
036099940
IL
207Q00000X
Family Medicine Physician
036084841
IL
207Q00000X
Family Medicine Physician
Primary
036085448
IL
207Q00000X
Family Medicine Physician
036112996
IL
207R00000X
Internal Medicine Physician
036089116
IL
207R00000X
Internal Medicine Physician
036094764
IL
207R00000X
Internal Medicine Physician
036103305
IL
207R00000X
Internal Medicine Physician
036108589
IL
208000000X
Pediatrics Physician
036089116
IL
208000000X
Pediatrics Physician
036094764
IL
208000000X
Pediatrics Physician
036103305
IL
208600000X
Surgery Physician
036095601
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0881270001
DME MAC, MEDICARE
IL
01
—
14D0902430
CLIA
IL
01
—
2523659
BC/BS GROUP PROVIDER #
IL
01
—
CK1050
RAILROAD MEDICARE
IL
Enumeration date
05/27/2005
Last updated
06/21/2018
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