Organization
CARLE CLINIC ASSOCIATION, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIRK MOBERG MD, PHD (SENIOR VICE PRESIDENT)
(217) 337-4105
Entity
Organization
Contact information
Practice address
1701 E CURTIS RD, CHAMPAIGN, IL 61822-9678
(217) 365-6210
Mailing address
1701 E CURTIS RD, CHAMPAIGN, IL 61822-9678
(217) 365-6210
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
060004307
IL
Other
Enumeration date
10/14/2008
Last updated
10/14/2008
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