National Provider Identifier Database

MID ILLINOIS MEDICAL CARE ASSOCIATES LLC
Rural Health


Contact Information

MID-ILLINOIS MEDICAL CARE ASSOCIATES, LLC
203 S. MAIN ST.
DIETERICH, IL62424
Phone: 217-925-5730
Fax: 217-925-5736
Website:
Specialty Taxonomy Code
* Rural Health 261QR1300X

* Indicates primary specialty

NPI Profile & details for MID-ILLINOIS MEDICAL CARE ASSOCIATES, LLC

NPI Number 1568619088
Legal business name
LBN
MID-ILLINOIS MEDICAL CARE ASSOCIATES, LLC
Authorized official EUGENE DUST - (PRESIDENT OF MID-ILLINOIS MEDICAL C)
Entity Organization
Organization subpart Yes
Enumeration date 08/27/2008
Last updated 06/27/2017 - About 9 years ago
Sole proprietor1 Not specified
Identifiers
  • IL License #: 036120332
  • IL Medicaid: 036120332

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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