Organization
CARLE CLINIC ASSOCIATION, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIRK MOBERG M.D., PH.D. (SENIOR VICE PRESIDENT)
(217) 383-3311
Entity
Organization
Contact information
Practice address
1702 S MATTIS AVE, CHAMPAIGN, IL 61821-5469
(217) 326-2030
Mailing address
1702 S MATTIS AVE, CHAMPAIGN, IL 61821-5469
(217) 326-2030
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
06004307
IL
Other
Enumeration date
03/07/2007
Last updated
08/22/2020
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